Apparatus and method for managing waste from patient care, maintenance and treatment

ABSTRACT

An apparatus and method for managing waste from patient care, maintenance, and/or treatment includes an inflatable bladder member disposed to support at least a first portion of the body of the patient. A flexible basin member is fitted over the bladder and receives waste materials, and a filter sheet is disposed atop the basin member. The basin member is connected to a liquid/gas separator and a vacuum blower. A liquid waste pump is connected to the separator to transfer liquid waste to a holding jug. A vacuum wand provides both suction and rinsing liquid via an on-demand pumping supply configuration that enables the rinsing liquid supplied from a rinse jug to be heated. Liquid levels in the rinse liquid jug, the holding jug, and the separator&#39;s holding reservoir are sensed by capacitive level sensing devices which supply signals to a microprocessor which controls various functions of the apparatus. Special inflatable sacks are provided to assist turning the patient to facilitate cleansing of the patient. Inflatable cushions receive the inflatable bladder member and dispose it to become coextensive with the support of the rest of the patient in a patient support apparatus, if desired.

The present application is a continuation-in-part application toapplication Ser. No. 07/792,216 filed Nov. 13, 1991, now U.S. Pat. No.5,269,030 and relates to apparatuses and methods for managing liquidwastes associated with patients confined to a hospital bed, wheelchair,treatment table or the like.

SUMMARY OF THE INVENTION

The management of incontinence of a patient is an especially burdensomechore. A large number of patients are unable to control their bowels andbladders or are sufficiently incapacitated that they are unable totransport themselves to conventional toilet facilities when the needarises. When such patients suffer an episode of bowel and/or bladderincontinence, they may be subjected to a relatively prolonged period oftime contacting the waste products so produced. In addition to beingsocially unacceptable for the patient, the waste products can cause skinmaceration and breakdown. Moreover, cleaning the patient and the beddingpose especially undesirable chores for the nursing staff and thusadversely affect nursing morale. Moreover, each episode can require upto 20 to 40 minutes of nursing time to clean up a single patient who hassuffered an incontinence event. For some patients, up to 40% of nursingtime devoted to such patient is devoted to clean up activitiesassociated with incontinence events. In addition, a single nurse isoften incapable of turning the patient to the degree needed for adequatecleansing of the patient after an incontinence event. Thus, more thanone member of the nursing staff must be involved in the clean up chore.

One method currently employed to manage bladder incontinence is tocatheterize the patient. This method does not require any positiveeffort or cooperation of the patient. However, in-dwelling cathetersoften cause infection which is one of the leading causes of death inolder patients who have been so catheterized.

Devices such as disclosed in U.S. Pat. No. 4,631,762 to Fugett, requirethe patient to be aware that an incontinence event is imminent andfurther require the patient to be able to indicate same to the nursingstaff or to take action to activate the device to assume a configurationready to accommodate an incontinence event. For example, the Fugettdevice requires a section of the mattress to be removed and a toiletseat to be raised flush with the level of the mattress. Other deviceswhich require reconfiguration before they are ready to accommodate anincontinence event, are disclosed in U.S. Pat. Nos. 3,014,224 to Hall;3,129,438 to Hall; 3,503,083 to Barnett; 3,562,824 to White; 3,605,138to Tucker; 4,054,959 and 4,085,471 to DiMatteo et al; 4,258,445 to Zur;4,821,348 to Pauna; 4,754,508 to Nishiguchi; 4,800,599 to Korchinski etal; 4,805,249 to Usman et al; and 5,001,790 to Kuhn. Moreover, suchdevices can require significant moving about of the patient. Suchmovement is particularly undesirable for certain types of patients, forexample those with sensitive skin conditions like decubitus ulcers.Furthermore, such devices are not readily adaptable to certain types ofpatient supports such as low air loss beds like the ones disclosed inU.S. Pat. Nos. 4,745,647 to Goodwin, 4,949,414 to Thomas et al, and5,003,654 to Vrzalik because of the extensive pneumatic "plumbing" whichexists beneath the main horizontal weight-bearing support structuresforming such beds.

A device such as disclosed in U.S. Pat. No. 5,023,967 to Ferrandcontains inflatable support cushions with a large opening 540 (FIGS. 58and 60) formed in the region of the cushions disposed to receive theexcretory organs of the patient so that any excreted wastes fall intothe opening. However, such devices severely restrict movement of thepatient in a manner that would misalign the patient's excretory organswith the opening in the cushions. Moreover, such devices fail to supportthe patient's backside in a manner sufficient for the patient's comfort.Other devices which have large nonsupportive openings in the middle ofthe patient support surface are disclosed in U.S. Pat. Nos. 3,757,355 toAllen et al and 2,656,549 to Obson et al.

Other devices such as disclosed in U.S. Pat. Nos. 3,757,356 to Freeman,4,870,710 to Hartmann, and 5,001,790 to Kuhn rest atop the normalsupport surface of the bed and thus involve all of the discomfortingdrawbacks of an uneven support surface.

Still other devices such as disclosed in U.S. Pat. No. 4,965,900 toSmith present several drawbacks, not the least of which is the failureto address the odor problem and the failure to signal the staff of theoccurrence of an incontinence event by any means other than the malodorarising long after the event. Moreover, such devices fail to dealeffectively with solid waste.

OBJECTS AND SUMMARY OF THE INVENTION

It is a principal object of the present invention to provide apressure-relieving waste management system that supports the weight ofthe patient at interface pressures less than 32 millimeters of mercuryat all patient and bed position attitudes and with reduced shear whenthe head of the bed is articulated at an incline to the horizontal.

It is a further principal object of the Present invention to provide awaste management system for urinary and fecal incontinence events andother liquid wastes associated with patient care and treatment, whereinthe system can be retrofitted as a modular add-on component to anexisting articulatable low air loss patient support system.

Another principal object of the present invention is to provide anincontinence management system that combines the attributes of beingeasy to use, technically advanced, superior to current methods,conserving nursing staff time and disposable materials, and eliminatingthe need for vigilance or cooperation by either the patient or thenursing staff prior to the incontinence event.

Still another principal object of the present invention is to provide anapparatus and method that manages wastes associated with patient carewherein the cooperation and/or effort of the patient is not required torender the apparatus and/or method effective to manage bowel and/orbladder incontinence of the patient.

An additional principal object of the present invention is to provide awaste management system that collects wastes associated with patientcare and patient treatment wherein the inventive system facilitatescontainment, ease of clean up, and disposal of such wastes.

A yet additional principal object of the present invention is to providean incontinence management system that collects urine and fecal matterin a manner which facilitates containment, ease of clean up, anddisposal of such wastes.

A further principal object of the present invention is to provide aliquid waste management system that keeps the patient drier and cleanerthan conventional technologies.

Still a further principal object of the present invention is to providean incontinence management system that reduces the time and effort thatnurses spend managing each patient incontinence event.

Another principal object of the present invention is to provide anincontinence management system that enhances patient care with means forassisting in turning the patient to either of the patient's sideswherein the effort of two hospital staff members is not required.

Yet a further principal object of the present invention is to provide anincontinence management system that reduces the cost associated withmanagement of patient incontinence.

Yet another principal object of the present invention is to provide anincontinence management system that reduces the amount of supplies usedper incontinence event.

Still another principal object of the present invention is to provide anincontinence management system that includes a non-abrasive skincleansing technique to reduce or prevent further damage to patients'tissues during clean-up after an incontinence event.

A further principal object of the present invention is to provide anincontinence management system that eliminates the need for invasivecatheterization for those patients not requiring urine outputmeasurements or for those patients for which it is acceptable to net outtotal waste fluids from rinse fluids.

Yet another principal object of the present invention is to provide anincontinence management system that controls odors associated withincontinence events.

Additional objects and advantages of the invention will be set forth inpart in the description which follows, and in part will be obvious fromthe description, or may be learned by practice of the invention. Theobjects and advantages of the invention may be realized and attained bymeans of the instrumentalities and combinations particularly pointed outin the appended claims.

To achieve the objects and in accordance with the purpose of theinvention, as embodied and broadly described herein, the apparatus formanaging waste associated with the care, maintenance and/or treatment ofa patient, whether from incontinence, bathing, or control of liquidsduring patient treatment, comprises a means for supporting at least aportion of the patient's body. The means for supporting a portion of thepatient's body desirably enables the portion of the patient's body to besupported in a pressure-relieving manner and typically at a level thatis coextensive with any support surface of any patient support apparatusthat may be used to support other portions of the patient's body.Accordingly, the means for supporting a portion of the patient's bodydesirably defines a surface which is at substantially the same height asthe support surface of any patient support surface being used inconjunction with the apparatus of the present invention. For example, ifa patient support surface is defined by the upper surfaces of inflatablesacks of a low air loss bed, the means for supporting a portion of thepatient's body desirably supports this portion of the patient's bodycoplanar with the support surfaces of the patient support apparatus.

As embodied herein, the means for supporting a portion of the patient'sbody includes a support member. The support member can be provided inthe form of an inflatable bladder which defines a gas tight enclosureconfigured to contain pressurized air. An alternative embodiment of thesupport member can include a support cushion formed of polyurethaneopen-cell foam, which is configured identically to the support bladder.The support member desirably defines a plurality of cylindrical fingerswhich rise vertically above the floor of the support member. Thetransverse cross-sectional shape of each finger can be circular or canbe a polygonal shape. The free end of each finger defines a patientsupport surface disposed to support the weight of a portion of the bodyof the occupant of the apparatus of the present invention. The pluralityof fingers can be arrayed in a regular pattern in which the pressureexerted on the body of the patient amounts to less than the typicalcapillary closure threshold pressure of 32 millimeters of mercury. Thefingers are completely separated from one another so that a gap existsbetween each finger along the entire length of each finger from thesupport surface to the floor. The ratio of the support area of eachfinger versus the area of the gap between the fingers is desirablygreater than one. The height of each finger must be tall enough toaccommodate deformation that would maintain the heaviest part of thepatient's body in the neutral plane. However, the height of each fingershould not be so tall relative to the transverse cross-sectional area ofeach finger, that the finger becomes unstable.

In accordance with the present invention, means can be provided forcatching the waste from an incontinence event, bathing, or othertreatment of the patient whose body is supported, at least as to oneportion of the patient's body, in the means for supporting the portionof the patient's body. The catching means desirably is supported by themeans for supporting the portion of the patient's body and desirably issupported between that portion of the patient's body and the means forsupporting same. As embodied herein, the catching means desirablyincludes a basin member which is configured to conform snugly to theconfiguration of at least the free ends of the support fingers of thesupport member. The configuration of the basin member desirablymaintains the gaps between the fingers along the entire length of theportions of the basin member conforming to the fingers. The basin memberis formed of material that is flexible enough so that the basin memberoffers no substantial impediment to collapsing into a flat surface whenthe support member collapses. The material forming the basin memberdesirably is liquid impermeable, such as very flexible elastomer havinga thickness of about 20 mils. Antimicrobial properties desirably areprovided in the material forming the basin member. The upper surface ofthe basin member desirably is formed of or coated with a layer ofhydrophobic material which assists in assuring gravity drainage ofliquid waste. The basin member includes a floor that is disposed beneaththe level of the support surfaces of the support fingers. The floor ofthe basin member desirably slopes toward at least one drain openingdefined through the floor of the basin member. Thus, the floor of thebasin member is desirably configured with a constantly declining heightgradient as one proceeds from the peripheral portion of the basin membertoward the drain opening. The drain opening of the basin memberdesirably is connected via a waste removal conduit to a drain fittingthat inserts through a centrally located opening defined through thebase portion of the support member.

In an alternative embodiment, the basin member can also define aplurality of grid configurations. Each grid configuration can bedisposed in one of the portions of the basin member that is locatedabove one of the support surfaces of one of the support fingers of thesupport member. Each grid configuration defines a local exteriortopography formed of a plurality of slightly raised portions separatedfrom one another by recessed channel portions. While the raised portionsmay be providing support to the body of the patient, the channelportions assure rapid liquid drainage away from the body of the patient.

In further accordance with the present invention, the catching means caninclude a liquid permeable filter sheet that is disposed to be carriedabove the basin member and closer to the patient's body than the basinmember. As embodied herein, the liquid permeable filter sheet isdisposed to be carried atop the basin member by the grid configurationsections and constitutes a section of the catching means that ispermeable to liquids. The filter sheet is configured to trap largersolid waste material and acts as a filter to prevent these largerparticulates from clogging the basin member and a waste removal conduit(described hereafter), which desirably is connected to the drain openingof the basin member. The filter sheet desirably defines a fabric, suchas a flexible screen, having a plurality of small individual pores. Thefilter sheet desirably should be formed of material that isantimicrobial, hypoallergenic, flame retardant, sufficiently hydrophobicso as to dry quickly, odor resistant, bacteriostatic, and non-stainingfor repeated use in an environment that anticipates staining from urine,fecal matter, and fluids normally found and used in the hospitalenvironment. In addition, the material forming the filter sheet shouldhave a very high tensile strength that is at least equal to the tensilestrength of current hospital draw sheets and have a, very smallcoefficient of friction to facilitate use of the filter sheet as a drawsheet. The filter sheet desirably has reinforced edges forming acontinuous border around the portion containing the small pores. In analternative embodiment, the filter sheet can be provided with handles orgrip openings secured to the border portions.

In further accordance with the present invention, a means can beprovided for detachably securing the filter sheet against movement awayfrom a position resting over the basin member. As embodied herein, thefilter sheet's detachably securing means desirably includes elongatedsubstrates carrying hook-and-loop fasteners and disposed horizontallynear the edges of opposite sides of the exterior surface of the filtersheet. These horizontally disposed substrates are mateable withsubstrates carrying hook-and-loop fasteners and disposed vertically nearthe edges of opposite ends of the exterior surfaces of the side panels.The side panels are themselves attached to the free endwall surfaces ofan adaptor shell that is described hereafter. The inside surfaces of theside panels can be provided with a plurality of other snaps which aredetachably attachable to a plurality of mating snaps (describedhereafter) of air inflated cushions (described hereafter) and thus holdthe filter sheet in place yet permit disengagement of the filter sheetby separating the mating hook-and-loop fasteners whenever the use of thefilter sheet as a draw sheet is desired. In an alternative embodiment,the filter sheet can be provided with a plurality of fastening means inthe form of snaps that are mateable with other snaps mounted on theexterior surfaces of the side panels. The fastening end of the filtersheet snaps desirably can be exposed for service on the surface of theborder portions of the filter sheet.

In further accordance with the present invention, means can be providedfor removing the waste materials that are caught by the catching means.As embodied herein, the waste removing means desirably includes at leastone waste removal conduit that is configured to be connected incommunication with at least one drain opening of the basin member.Desirably, a drain fitting extends through the drain opening and isconnected to the waste removal conduit. The removing means alsodesirably includes a holding reservoir connected in communication withthe waste removal conduit. As embodied herein, the removing meansfurther includes a vacuum blower that is configured and disposed so thatit can create a suction force in at least the catching means and thewaste removal conduit and is connected in communication with the holdingreservoir.

In further accordance with the present invention, the removing means caninclude a means for separating the liquid from the air in the fluid thatis removed from the catching means. As embodied herein, the separatingmeans desirably includes a separator tube that is disposed so that thewaste removal conduit communicates with the holding reservoir via theseparator tube. The separator tube desirably is configured with a 180ocurved portion that is disposed in the path of the waste fluid thatexits the waste removal conduit and before the fluid enters the holdingreservoir. The curved portion of the separator tube is disposed insidethe holding reservoir and is configured with a slot directed to pointgenerally downwardly toward the bottom of the holding reservoir so thatcentrigugal force separates the liquid from the air and directs theliquid out of the tube through the slot and toward the bottom of theholding reservoir.

In further accordance with the present invention, the removing means caninclude a portable, manually directed suction device in the form of avacuum wand that is connected in communication with the holdingreservoir and the vacuum blower via a flow diverter valve so that thevacuum blower is disposed in a manner that can create a suction force atthe free end of the vacuum wand. The suction line that connects the tipof the vacuum wand in communication with the vacuum blower can beprelubricated by a spray of liquid that is introduced when the suctionoperates through the vacuum wand.

In further accordance with the present invention, a means can beprovided for controlling operation of the vacuum blower in response toactivation of the vacuum wand. As embodied herein, the vacuum blowercontrol means can include a controller that can be programmed toactivate the vacuum blower to a higher speed than the blower's normalcontinuous running speed upon receipt of a signal from the activationswitch for operating the vacuum wand in a suction mode in communicationwith the vacuum blower. At the higher speed, the vacuum blower providessufficient suction to both the wand and to the waste removal conduit tomove waste fluid out of the basin member and into the holding reservoir.

In accordance with the present invention, a means can be provided thatprevents operation of the vacuum blower from drawing wastes out of theremoving means and backing same into the vacuum blower conduits whichenable the vacuum blower to communicate with the interior of the holdingreservoir. As embodied herein, the waste backup prevention means caninclude a controller which receives a signal from a high liquid levelsensor disposed at a high level in the holding reservoir and turns offthe blower while signaling the operator that service is required.

In still further accordance with the present invention, a means can beprovided for controlling odor. As embodied herein, the odor controlmeans can include a cannister containing an odor filter such asactivated carbon and connected so that either the vacuum blower exhaustsinto and through the cannister or draws air into and through thecannister before the air enters the vacuum blower.

In yet further accordance with the present invention, the removing meanscan include a means for cleansing. As embodied herein, the cleansingmeans can include a rinse solution container for holding rinsesolutions. The cleansing means also can include a rinse solution conduitthat carries the rinse solution from the rinse solution container to thevacuum wand. The cleansing means also can include a rinse pump thatprovides the rinse solution under pressure to the vacuum wand. Thecleansing means also can include a rinse spray nozzle that is mounted onthe vacuum wand and through which the rinse solution is pumped by therinse pump upon activation of a rinse trigger. The spray nozzle isconfigured and disposed so that it does not come into contact with thetip of the vacuum wand and directs the spray at the base of the backside of the tip of the vacuum wand. The tip of the vacuum wand hassafety louvers on the back side so that suction can be applied via thistip directly to a surface without the pooling of rinse liquid. Thecleansing means also can include a means for regulating the temperatureof liquid provided to the spray nozzle. The cleansing means can includea splash guard configured and disposed to intercept back-splashingliquid dispensed from the nozzle. The cleansing means can include ameans for providing rinse solution on demand to the nozzle and withoutsurges of rinse solution.

In accordance with the present invention, means can be provided forreceiving the rinse solution container. As embodied herein, the rinsecontainer receiving means desirably includes a first housing configuredfor receiving the rinse solution container. The first housing desirablyincludes a slide receptacle configured for slidably engaging a mutuallyconfigured portion of the rinse solution container.

In accordance with the present invention, a means can be provided fordetecting a predetermined level of liquid in the rinse solutioncontainer and providing a signal upon detecting same. The rinse solutionlevel detecting means can include a liquid Level proximity sensor havinga portion permanently mounted and disposed in the first housing for therinse solution container and producing an electrical response andproviding same to a detection circuit when the level of liquid withinthe rinse container attains proximity to the liquid level sensor. Thedetection circuit can be electrically connected to a controller such asa microprocessor, which in turn can activate an alert signal on acontrol panel to advise the operator to refill the rinse solutioncontainer with liquid.

In accordance with the present invention, means can be provided so thatthe rinse pump automatically provides rinse solution to the vacuum wandwhenever the vacuum wand is going to be used by the operator. Asembodied herein, the automatic activation means for the rinse pump caninclude a pressure switch and an accumulator disposed in the rinsesolution conduit. In an alternative embodiment, a microswitch can beactivated to turn on the rinse pump whenever the operator tries to usethe vacuum wand. Desirably, the controller should be preprogrammed tocheck the liquid level sensor in the rinse solution container so thatthe rinse pump does not operate if the level of rinse solution insidethe rinse container is too low.

In still further accordance with the present invention, means can beprovided for detecting when the rinse solution container is securablyreceived by the housing. As embodied herein, the securably receiveddetecting means is connected to provide a signal to the controller,which the controller in turn can provide to a control panel. Thesecurably received detecting means can include an electrical circuitwhich includes a microswitch electrically connected in communicationwith the controller and a spring-biased plunger permanently mounted anddisposed in the first housing for the rinse container, whereupon themicroswitch causes the circuit to change its electrical status when therinse solution container is securably received by the housing.

The first housing can be provided with a means for automaticallycoupling the liquid level detecting means to the controller when therinse solution container is received by the first housing. Suchautomatic coupling means can include a spring-loaded plunger mounted inthe first housing to engage the rinse solution container and change thestatus of the micro-switch when the rinse solution container is receivedby the first housing.

In yet further accordance with the present invention, the first housingcan include means for automatically connecting the rinse solutioncontainer in communication with the rinse spray nozzle of the vacuumwand when the housing receives the rinse solution container. As embodiedherein, the rinse container connecting means can be configured toprevent any of the rinse solution from escaping the rinse solutioncontainer when the connecting means is disengaged from the housing. Theconnecting means desirably includes a dripless connector having a malemember and a female member, each provided with spring-loaded poppet typeclosures that seal their openings unless mutually engaged to oneanother. One of the members is formed as part of an inlet/outlet valveformed in the exterior of the rinse solution container, and can beconnected to a siphon member having its free end disposed just below thelevel of the level sensor. The other of the connector members can beattached to the exterior of the housing and disposed in communicationwith the rinse solution conduit that connects to the vacuum wand.

In still further accordance with the present invention, means can beprovided for collecting the waste that is removed from the catchingmeans by the removing means. The waste collecting means desirably isdisposed to be in communication with the removing means and contains thewaste in a manner that isolates the waste from the patient andfacilitates the eventual disposal of the contained waste by personsattending the patient. As embodied herein, the collecting meansdesirably includes a waste collection container. The waste collectioncontainer is desirably provided with similar means to those that areprovided for the rinse solution container, except that the level sensingmeans detects a full container rather than an almost empty container andaccordingly is disposed near the top of the container.

As embodied herein, the collecting means can further include a wastetransfer pump and waste transfer conduits. The waste transfer conduitsconnect an outlet opening defined in the bottom of the holding reservoirto the waste collection container via the waste transfer pump.

In still further accordance with the present invention, a means can beprovided for automatically controlling the operation of the wastetransfer pump so as to transfer waste from the removing means to thewaste collection container whenever a predetermined level of waste hasaccumulated within the holding reservoir. As embodied herein, the wastetransfer pump control means desirably includes another liquid levelsensor which can be disposed with respect to the holding reservoir so asto detect when the waste transfer pump should be activated for thepurpose of pumping waste from the holding reservoir into the wastecollection container. One embodiment of a suitable liquid level sensorcan include a capacitive liquid level proximity sensor disposed in thevicinity of the bottom of the holding reservoir. In addition, the meansfor automatically controlling operation of the waste transfer pump so asto transfer waste from the removing means to the collection means, canfurther include an electrical circuit which includes the sensor. Theelectrical circuit powers a signal and provides this signal to thecontroller. Upon receipt of this signal from the electrical circuit, thecontroller can perform any of a number of preprogrammed functions oroperations, one of which is activating the waste transfer pump. However,the controller additionally can be preprogrammed to check the liquidlevel sensor in the waste collection container so that operation of thewaste transfer pump does not occur if the level sensor indicates thatthe level of Waste inside the waste container is too high.

In yet further accordance with the present invention, a means can beprovided for automatically detecting a predetermined level of liquidwithin the holding reservoir and providing a signal upon detection ofsame. As embodied herein, this liquid level detecting and signallingmeans desirably includes a capacitive proximity liquid level sensorconfigured and disposed for detecting and signaling when the holdingreservoir becomes filled to a predetermined proportion of its capacity.The sensor is part of an electrical liquid level detection circuit,which provides a signal to the controller depending upon the absence orpresence of liquid at a predetermined level inside the holdingreservoir. The controller activates an alerting signal appropriate tothe signal sent by the detection circuit.

Each of the containers, the waste collection container and the rinsecontainer, desirably is separately configured so that each providesmeans for preventing interchange of the waste collection container withthe rinse solution container when being connected to the waste managingmeans of the present invention. Alternatively, either the connectors foreach container would be differently configured or located in arelatively different position. In either case, it would be impossible tointerchange the two containers. Each of the connectors desirably isformed as a quick-disconnect type connector which automatically remainsopen when the container is connected so as to receive waste andautomatically remains sealed when the container is disconnected so thatthe container can be transported to a remote site for refilling oremptying, as appropriate.

In yet further accordance with the present invention, a means can beprovided for keeping track of the amount of fluids that is expelled bythe patient through incontinence events. As embodied herein, theexpelled fluid accounting means can include forming the waste collectioncontainers of translucent material and providing volume graduations onthe inside or outside surfaces of the container to provide a visuallyobservable level indicator for the fluid inside the container.

In still further accordance with the present invention, a means can beprovided for detecting and signalling a waste-producing event. Thedetecting and signalling means desirably communicates with at least oneof the catching means, the removing means, and the collecting means. Asembodied herein, the detecting and signalling means can include amoisture sensor, which is disposed so that it can detect liquid in atleast one of the catching means, the removing means, and the collectingmeans. The moisture sensor can be disposed in a drain fitting near theupper region of the waste removal conduit just below the catching meansand can include a pair of electrically conducting rings secured to theinside wall of the fitting and spaced from one another by aboutone-quarter inch. Desirably, the rings are electrically connected in anelectrical circuit that is complete when moisture flows between the tworings. A signalling mechanism can be provided on a control panel so thatwhen moisture flows between the two rings, a signal is sent to acontroller, which in turn activates the signalling mechanism on thecontrol panel.

In an alternative embodiment of the present invention, a means can beprovided for controlling operation of the vacuum blower in response tomoisture detection by the moisture detecting and signalling means. Inthis alternative embodiment, the vacuum blower control means can includea controller that can be programmed to activate the vacuum blower to ahigher speed upon receipt of a signal from the moisture detectioncircuit indicating that moisture has entered the upper region of thewaste removal conduit. At the higher speed, the vacuum blower providessufficient suction to pull the moisture out of the waste removal conduitand into the holding reservoir.

In accordance with the present invention, a means can be provided forcounting the number of waste producing events that occur during a givenperiod of time. As embodied herein, the counting means can include acontroller that is suitably programmed to keep track of the number ofsignals received from the moisture detecting and signalling means duringa given interval of time.

In further accordance with the present invention, a means can beprovided for adapting the managing means apparatus of the presentinvention to be carried by the frame of a patient support apparatus. Thecarrying adapting means desirably is supported by the frame of thepatient support apparatus. As embodied herein, the carrying adaptingmeans can include an adaptor shell that defines a bottom surfaceconfigured for being carried by the frame of the patient supportapparatus. The adaptor shell defines a receiving opening in a centrallocation of the shell. The receiving opening is configured forsecuringly and supportingly receiving the support member of the managingmeans apparatus of the present invention in a manner that disposes thesupport surfaces of the support member substantially in the same planewith the support surfaces of the patient support apparatus. In a low airloss bed for example, this patient support surface is defined by theupper surfaces of the sacks of the low air loss bed. The adaptor shelldesirably is formed by a plurality of individual inflatable cushionsthat combine to form a generally U-shaped external configuration whichdefines the receiving opening. An elongated slot can be defined in theintermediate portion of wide cushions located near the center of theadapter shell. This slot provides access for the waste removal conduitthat connects the holding reservoir in communication with the drainopening of the basin member. Desirably, the cushions are formed asair-tight enclosures and are inflatable with pressurized air.Alternatively, the adaptor shell can be formed of urethane foam.

As embodied herein, the means for carrying the managing means canfurther include a foot-mounted container that includes an enclosure anda base plate which slides horizontally into and out of the enclosure.The holding reservoir and the vacuum blower can be mounted on the baseplate. Alternatively, the carrying means can be formed as a mobileservice cart, which is either upright or has an undercarriage with a lowprofile that can be slid beneath one end of the frame of the patientsupport apparatus.

In yet further accordance with the present invention, a means can beprovided to assist in turning the patient to facilitate cleansing aftera waste-producing event. Desirably, the turning means is carried by theframe of the patient support apparatus and can include a plurality ofspecially configured turning sacks which are provided with pressurizedair in one or more configurations under the control of a controller. Inaddition, an air flow diverter valve is provided for the cushions ineach of the air pressure zones of the patient support apparatus and canbe configured and actuated by the controller to enable the controller toselectively inflate or deflate either one side or both sides of theturning sacks. In an alternative embodiment, a turning sack can bealternated with a conventional low air loss bed support sack. In thealternative embodiment, a pair of air flow diverter valves can beconfigured and disposed in series and actuatable by the controller toenable the controller to selectively inflate or deflate either theturning sacks or the conventional support sacks.

In yet further accordance with the present invention, a means can beprovided for alerting and/or informing the operator to variousconditions of the apparatus of the present invention. The alerting andinforming means can include a control panel that is electricallyconnected to the controller and provided with various indicators thatthe controller can operate as well as reset after the indicator has beenoperated.

The accompanying drawings, which are incorporated in and constitute apart of this specification, illustrate one embodiment of the inventionand, together with the description, serve to explain the principles ofthe invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 schematically illustrates a preferred embodiment of the presentinvention viewed from an elevated side plan perspective in a low airloss patient support system;

FIG. 1A schematically illustrates components of a preferred embodimentof the present invention from an elevated perspective view;

FIG. 2 schematically illustrates components of an alternative embodimentof the present invention from an elevated perspective view;

FIG. 2A schematically illustrates portions of components of analternative embodiment of the present invention from a partially cutaway side plan view;

FIG. 3 schematically illustrates a representative portion of a gridconfiguration structure provided on the surface of a portion of analternative embodiment of a component of the present invention;

FIG. 4 schematically illustrates a side plan view of components of apreferred embodiment of the present invention;

FIG. 4A schematically illustrates a cross-sectional view of componentsof an alternative embodiment of the present invention;

FIG. 5 schematically illustrates a portion of a component of a preferredembodiment of the present invention with portions of the component cutaway for illustrating aspects normally hidden from view;

FIG. 6 schematically illustrates components of the present inventionfrom an elevated perspective view;

FIG. 7 schematically illustrates a pattern for portions of components ofa preferred embodiment of the present invention from a top plan view;

FIG. 8 schematically illustrates an elevated perspective view ofcomponents of an alternative embodiment of the present invention;

FIG. 9 presents a schematic representation of the interaction andcooperation of various components of an alternative embodiment of thepresent invention;

FIG. 10 schematically illustrates components of an alternativeembodiment of the present invention from an elevated perspective view;

FIG. 11 schematically illustrates components of an alternativeembodiment of the present invention from a side plan view with portionscut away;

FIG. 12 schematically illustrates components of an alternative preferredembodiment of the present invention from a side plan view with portionsindicated in phantom by the dashed lines;

FIG. 12A schematically illustrates components of the alternativepreferred embodiment of the present invention shown in FIG. 12, but froma front plan view with portions indicated in phantom by the dashed linesand with portions partially cut away;

FIG. 13 schematically illustrates components of an alternativeembodiment of the present invention from an elevated perspective view;

FIG. 14 schematically illustrates components of an alternativeembodiment of the present invention from a side plan view with portionscut away;

FIG. 14A illustrates an expanded cross-sectional view of details ofcomponents of an embodiment of the present invention illustrated in FIG.14;

FIG. 14B illustrates an expanded front plan view of components of thepresent invention illustrated in FIG. 14;

FIG. 15 schematically illustrates components of an alternative preferredembodiment of the present invention from a side plan view with portionsindicated in phantom by the dashed lines;

FIG. 16 schematically illustrates components of the alternativepreferred embodiment of the present invention shown in FIG. 15, but froma front plan view with portions indicated in phantom by the dashed linesand with portions partially cut away;

FIG. 17 schematically illustrates components of an alternativeembodiment of the present invention from an elevated perspective viewwith portions cut away and separated from one another;

FIG. 18 schematically illustrates the assembled components of FIG. 17from a side plan view with portions cut away;

FIG. 18A schematically illustrates components of a preferred embodimentof the present invention from a view that is partially a side plan viewand partially a cross-sectional view with portions cut away;

FIG. 19 schematically illustrates components of a preferred embodimentof the present invention from a top plan view;

FIG. 20 schematically illustrates the foam member component of FIG. 4A,but from a bottom plan view;

FIG. 21 schematically illustrates an alternative embodiment ofcomponents of the present invention from a side cross-sectional view;

FIG. 22 schematically illustrates components of the present inventionfrom a top cross-sectional view looking in the direction of arrows22--22 in FIG. 21;

FIG. 23 schematically illustrates components of an alternativeembodiment of the present invention from a front plan view;

FIG. 23A schematically illustrates components of a presently preferredembodiment of the present invention from a front plan view;

FIG. 24 schematically represents a top plan view of a preferredembodiment of a floor of a basin member component of the presentinvention for the purpose of illustrating one desirable configuration ofthe slope of the floor;

FIG. 25 schematically illustrates a partial cross-sectional view of aportion of a component of an alternative embodiment of the presentinvention shown in FIG. 4A;

FIG. 26 schematically illustrates components of an alternativeembodiment of the present invention from a side plan view with portionsindicated in phantom by the dashed lines and portions cut away;

FIG. 26A schematically illustrates a partial side plan view ofcomponents of a preferred embodiment of the present invention withportions broken and other portions shown in phantom by dashed lines toillustrate two alternative positions of certain components;

FIG. 26B schematically illustrates a partial side plan view ofcomponents of a preferred embodiment of the present invention withportions broken and other portions shown in phantom by dashed lines toillustrate two alternative positions of certain components;

FIG. 27 is a schematic representation of an alternative embodiment ofcomponents of a preferred embodiment of the present invention;

FIG. 28 illustrates a front plan view of components of a preferredembodiment of the present invention with portions broken and otherportions shown in phantom by dashed lines;

FIG. 29A illustrates a rear plan view of an alternative embodiment ofwaste collection container of the present invention with portions cutaway to illustrate features on the front of the container and portionsshown in phantom by dashed lines;

FIG. 29B illustrates a rear plan view of an alternative embodiment ofrinse solution container of the present invention with portions cut awayto illustrate features on the front of the container and portions shownin phantom by dashed lines;

FIG. 30 schematically illustrates components of a preferred embodimentof the present invention from an elevated perspective view with portionscut away and portions shown in phantom;

FIG. 31 schematically illustrates components of a preferred embodimentof the present invention from a side cross-sectional view looking in thedirection of arrows 31--31 in FIG. 30;

FIG. 32 schematically illustrates a an expanded, partial, sidecross-sectional view looking in the direction of arrows 32--32 in FIG.30;

FIG. 33 schematically illustrates components of a preferred embodimentof the present invention from a side cross-sectional view looking in thedirection of arrows 33--33 in FIG. 30;

FIG. 34 schematically illustrates components of a preferred embodimentof the present invention from a partial, top plan view looking in thedirection of arrows 34--34 in FIG. 33;

FIG. 35 is an elevated perspective view of components of a preferredembodiment of the present invention;

FIG. 36 is an elevated perspective view of components of the preferredembodiment of the present invention shown in FIG. 30;

FIG. 37 is an elevated perspective view of components of the preferredembodiment of the present invention shown in FIG. 30 with portionsomitted, portions cut away, and portions shown in phantom (dashed line);

FIG. 38 presents a schematic representation of the interaction andcooperation of various components of a preferred embodiment of thepresent invention;

FIG. 39 presents a schematic representation of the conduits carryingpressurized gas to the various inflatable components of a preferredembodiment of the present invention;

FIG. 40 schematically illustrates components of a preferred embodimentof the present invention from an elevated perspective view;

FIG. 41 schematically illustrates air flow diverter valve components ofa preferred embodiment of the present invention in differentconfigurations corresponding to several different operating modes;

FIGS. 42 and 42A schematically illustrate a preferred arrangement forliquid level sensing components used in connection with the rinse jug,the waste jug, and the waste reservoir of a preferred embodiment of thepresent invention;

FIG. 43 schematically illustrates components of a preferred embodimentof the present invention from a side plan view;

FIG. 44 schematically illustrates components of a preferred embodimentof the present invention from a side plan view;

FIG. 45 illustrates an elevated perspective view of a preferredembodiment of the two-way, three-port, vacuum flow diverter valvecomponent of the present invention;

FIG. 46 is a partial side cross-sectional view looking in the directionof arrows 46--46 in FIG. 45;

FIG. 47 schematically illustrates components of a preferred embodimentof the present invention from a top cross-sectional view looking in thedirection of arrows 47--47 in FIG. 45;

FIG. 48 is an elevated perspective view of a siamese turning sack withportions cut away and portions shown in phantom;

FIG. 49A schematically illustrates reservoir/separator components of apreferred embodiment of the present invention from a side plan view withportions cut away and portions shown in phantom;

FIG. 49B schematically illustrates components of a preferred embodimentof the present invention from a top plan view looking in the directionof arrows 49B--49B in FIG. 49A with portions cut away and portions shownin phantom;

FIG. 49C schematically illustrates components of a preferred embodimentof the present invention from a front plan view looking in the directionof arrows 49C--49C in FIG. 49A with portions cut away and portions shownin phantom; and

FIG. 49D schematically illustrates reservoir/separator components of apreferred embodiment of the present invention from an elevatedperspective view.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

Reference now will be made in detail to the presently preferredembodiments of the invention, one or more examples of which areillustrated in the accompanying drawings. Each example is provided byway of explanation of the invention, not limitation of the invention. Infact, it will be apparent to those skilled in the art that variousmodifications and variations can be made in the present inventionwithout departing from the scope or spirit of the invention. Forinstance, features illustrated or described as part of one embodiment,can be used on another embodiment to yield a still further embodiment.Thus, it is intended that the present invention cover such modificationsand variations as come within the scope of the appended claims and theirequivalents.

In accordance with present invention, there is provided a low air losspatient support apparatus which incorporates means for managing wastefrom a patient who is supported at least in part on patient supportsurfaces of the low air loss patient support apparatus. The numeral 30in FIG. 1 refers generally to a presently preferred embodiment of a lowair loss patient support apparatus which incorporates means for managingwaste from a patient who is supported at least in part by patientsupport surfaces of apparatus 30. As is conventional, bed 30 includes aframe having rigid members for carrying a plurality of sacks 44 whichare configured to be inflatable with a pressurized gas. As embodiedherein and shown in FIGS. 1 and 1A for example, the frame can include alower frame 34 and an upper frame 36. Each of lower frame 34 and upperframe 36 can be formed of a pair of opposed, rigid tubular frame rails38 for carrying various components of the present invention. As shown inFIG. 1A for example, each tubular frame rail 38 defines a rectangularconfiguration including an interior sidewall 40 defining the height offrame rail 38 and disposed at a right angle to a top wall 42 definingthe width of frame rail 38. As embodied herein and shown in FIG. 1 forexample, upper frame 36 provides a rigid support beneath a plurality ofinflatable sacks 44 carried by the frame. In order to avoid undulycomplicating FIG. 1, the articulating sections of upper frame 36 are notspecifically illustrated. Similarly, the side panels normally attachedto snaps mounted on the outside surfaces of the end walls of air sacks44 are not illustrated in FIG. 1 in order to avoid unduly complicatingthe drawing. However, examples of such side panels are disclosed in eachof U.S. Pat. Nos. 4,745,647 to Goodwin; 4,768,249 to Goodwin; 4,914,760to Hargest et al; 4,942,635 to Hargest et al; 4,949,413 to Goodwin;4,949,414 to Thomas et al; 5,035,014 to Blanchard; and 5,051,673 toGoodwin; the entire disclosures of each of the foregoing patents beinghereby incorporated into this patent application by this reference.

Air sacks 44 are constructed and configured in a manner that permitsthem to define a support surface that conforms to at least a firstportion of the body of the patient. The support surface supports thepatient above the frame when the sacks are inflated with the pressurizedgas. Examples of details concerning the frame, the sacks, and the mannerof articulating the frame and supplying and controlling pressurized gasto the sacks are disclosed in one or more of the above-referenced U.S.Patents.

In accordance with the present invention, means are provided formanaging waste associated with the care and/or treatment of a patient.The waste managing means of the present invention effectively managesdifferent types of wastes, including, but not limited to, wastes frompatient incontinence, patient bathing, patient wound irrigation, andemergency treatment of a patient. Moreover, different embodiments of thewaste managing means of the present invention can be provided to suitdifferent types of beds, different environments, and different users.For example, an embodiment of the waste managing means can be providedfor managing incontinence from patients confined to wheelchairs. Anotherembodiment can serve as a bathing apparatus for patients who have verysensitive skin conditions. Yet another embodiment can serve as a workingsurface in a hospital emergency room setting in which trauma victims canbe treated while controlling and containing blood, other bodily fluids,and treatment fluids that are present in such environments. For purposesof illustrating the waste managing means of the present invention, anembodiment of the waste managing means will be described for a patientwhose body is supported at least in part on the support surface of a lowair loss patient support apparatus. Accordingly& the numeral 32 in FIG.1 refers generally to an embodiment of the waste managing meansassociated with the patient occupant of low air loss bed 30.

In accordance with the present invention, at least some portion of thepatient's body is supported by the waste managing means, which providesmeans for receiving (as by catching), removing, collecting andcontaining for disposal, waste from patient-related events, whether suchevents occur during routine patient care such as by patient incontinenceor bathing, or during patient treatment procedures, wherein such wastemanaging means operates independent of active cooperation of the patientprior to the occurrence of the waste-producing event, independent ofprepositioning the patient prior to the occurrence of thewaste-producing event, independent of active cooperation of the hospitalstaff prior to the occurrence of the waste-producing event, andindependent of movement of any section of the waste managing means priorto the occurrence of the waste-producing event.

While at least a first portion of the patient's body is supported in apatient support apparatus, such as a low air loss bed 30 for example,the waste managing means desirably includes means for supporting atleast a second portion of the patient. The second portion of the patientdesirably is supported at a level that enables the patient to besupported in the neutral plane. The body rests in its neutral plane whenthe body is supported so that its muscular/skeletal system is maintainedat equilibrium, i.e., without muscular tension. Thus, the second portionof the patient desirably is supported at a level that is coextensivewith the Way that the rest of the patient's body is carried by thesupport surface of the patient support apparatus and thus is desirablyat substantially the same height above the frame of the patient supportapparatus. Accordingly, the second portion supporting means defines afirst surface that is configured and disposed substantially coextensivewith the support surface of the patient support apparatus. Asillustrated in FIG. 1 in a low air loss patient support apparatus 30 forexample, the patient support surface is defined by the plurality ofupper surfaces 46 of the inflatable sacks 44. In embodiments of thewaste managing means intended to address patient incontinence, thesecond portion of the patient's body desirably includes the portion ofthe patient's body that defines the excretory organs of the patient.Moreover, the second patient body portion supporting means desirablyfunctions to support the second portion of the patient's body "coplanar"with the support surfaces 46 of the patient support apparatus 30. Inthis sense, the word "coplanar" defines a plane that follows along thecontour of the outline of the body of the patient being supported,rather than a strictly flat plane.

The second patient body portion supporting means includes a supportmember. The support member carries the weight of the second portion ofthe patient's body. The support member carries this weight in a mannerthat provides pressure relieving support to the second portion of thepatient's body. In this way, the support member the waste managing meanscan cooperate with a low air loss bed to provide overall pressurerelieving-support to the patient's entire body.

In one embodiment shown in FIGS. 2, 2A, and 5 for example, the supportmember of the waste managing means can be provided in the form of asupport bladder 48. In a presently preferred embodiment shown in FIGS.30-34 for example, the support member of the waste managing means can beprovided in the form of a support bladder 548 which is formed with aconfiguration similar to support bladder 48. The main difference is theconfiguration of fill-in cylinders 563 near the periphery of supportbladder 548. Each support bladder 48, 548 defines an envelope formed offlexible, elastic material that defines a gas tight enclosure configuredto contain pressurized air. Configured as such, the rigidity of supportbladders 48, 548 can be varied by varying the pressure of the gas,typically air, contained within same. Antimicrobial material could beimpregnated directly into the flexible material forming support bladders48, 548 and/or permanently bonded onto the surface of the flexiblematerial forming support bladders 48, 548.

The construction of support bladder 548 is the same as the constructionfor support bladder 48, which is described below. As illustrated in FIG.5 for example, support bladder 48 desirably is formed of two pieces, atop piece 49 and a bottom piece 51. As illustrated in FIGS. 2A and 5 forexample, top piece 49 of support bladder 48 desirably is a unitarystructure defining a plurality of cylindrical fingers 50 as well as theadjoining floor portions 52 which define the separation between fingers50 and form the upper floor of the support bladder. Bottom piece 51forms the continuous flat underside of the base portion 54 of thesupport bladder and is sealed to top piece 49 continuously around theperipheral border portions 53 and at selected points 55 in the interiorportions away from the periphery. As shown schematically in FIG. 5 forexample, each of top and bottom pieces 49, 51 of support bladder 48 canbe formed by a dip molding process which uses a molding tool thatdefines stand-off adhesive points 55 of bladder 48. Top piece 49 can beattached in air tight fashion to bottom piece 51 by radio frequency (RF)sealing or adhesive bonding the periphery 53 and stand off adhesivepoints 55. This type of construction leaves channels 56 defining largeopen areas for air to travel between cylinders 50. These large internalchannels 56 permit air to be distributed quickly and enter each of thecylinders 50 from one or more common fittings 58. Thus, support bladder48 responds quickly to equalize pressures between cylinders 50.Moreover, the size of channels 56 poses no impediment to rapid deflationof support bladder 48 for purposes of implementing a CPR procedure.

Another presently preferred embodiment of the support bladder isschematically illustrated in FIGS. 19 and 39 for example. In thisembodiment, which is constructed as described above for bladder 48 and548, three separately inflatable sections X, Y, and Z are defined bycontinuous peripheral sealed borders 53. As shown schematically in FIG.39 (not shown in the top plan view of FIG. 19), each section X, Y, Z isprovided with a pair of air inlet fittings 533 through which pressurizedair can be supplied from a blower 304. Depending on the length of eachsection, each section X, Y, Z can be provided with its own opening 72 toaccommodate a drain opening 66 (described below). The embodiment of thesupport bladder shown in FIGS. 19 and 39 is desirable when the wastemanaging means of the present invention is to be carried on anarticulating surface. Then each section X, Y, Z of bladder 48 can becarried on a separate articulating portion of the articulating surface.If the FIG. 19 embodiment of support bladder 48 were to be provided fora low air loss bed 30 such as shown in FIG. 1 for example, then sectionX would correspond to the calf zone of bed 30, section Y wouldcorrespond to the buttocks zone of bed 30, and section Z wouldcorrespond to the lower torso zone of bed 30. The FIG. 19 embodiment ofsupport bladder 48 also is desirably provided for a low air loss surfacefor sponge bathing a patient or for treating trauma patients in ahospital emergency room setting.

An alternative dip molding manufacturing technique for producing asupport bladders 48, 548 for the present invention is described in partin one or more of U.S. Pat. Nos. 4,698,864; 4,541,136; 3,605,145;3,870,450 and 4,005,236 to Graebe, the disclosures of which patents areall hereby incorporated into this patent application by this reference.However, the technique described in these patents is desirably Modifiedto provide more open channels 56 between cylinders 50.

The following description of support bladder 48 with cylinders 50,applies equally well to support bladder 548 with cylinders 550 shown inFIGS. 19 and 30 for example. As described above and illustratedschematically in FIG. 5 for example, support bladder 48 defines aplurality of cylindrical pockets 50 which are inflatable with air toform air-filled cylindrical columns 50, also referred to as cylinders 50or fingers 50. Air-filled cylindrical columns 50 are pressure-relievingcylinders. As shown in FIGS. 2, 4, 5 and 19 for example, eachcylindrical column 50 has a circular transverse cross-section. However,other shapes, such as a triangular shape, a square shape, a rectangularshape, a pentagonal shape, a hexagonal shape, or another polygonal shapeor closed curvilinear shape, can be used.

Each cylindrical column of the support member defines a discrete supportfinger 50 that is disposed adjacent to, but separated from, othersupport fingers 50 in a predetermined pattern of arrangement. As shownin FIGS. 2, 4, 5 and 19 for example, each support finger 50 (or 550,FIG. 30) has a free end which defines a patient support surface 60 (or560, FIG. 30). Each patient support surface 60 of each finger 50 isdisposed to support the weight of a second portion of the body of theoccupant of the waste managing means of the present invention. When theinvention is provided in an embodiment for incontinence management,desirably the portion of the patient's body defining the excretoryorgans is disposed to be supported by the patient support surfaces 60 ofthe support member. The pressure of the air in each cylindrical column50 desirably is the same for each column located within a particularpatient support zone (see FIGS. 19 and 39 for example) of the bed orother structure in which the apparatus of the present invention is beingused.

In an alternative embodiment of the support member, the support membercan be defined as a support cushion formed of a resilient foam member.However, such an embodiment would not be recommended for an applicationthat required a rigid surface for performing CPR. The rigidity of thesupport cushion embodiment of the support member can be varied only byvarying the density and composition of the resilient foam used to formthe cushion when the cushion is originally manufactured. Theconfiguration of the support cushion embodiment of the support member isthe same as described above with regard to support bladder 48 and thusincludes a plurality of spaced apart cylindrical fingers 50.

Assuming that the individual cylinders 50 of the support member arearrayed according to a uniform pattern and assuming further that each ofcylinders 50 is identically configured, the size and configuration ofthe support member is defined by one or more of a number of parameters.These parameters include: the rigidity/flexibility of the materialforming the cylinders 50 (in an inflatable embodiment of the supportmember, the operating pressures of the support member also must be takeninto account); the cylinder height measured from adjoining floorportions 52 (or 552, FIGS. 18A, 31 and 32) to support surfaces 60 (or560, FIGS. 31 and 32); the area of the support surface 60 of the freeend of each cylinder 50; the number of cylinders 50 per unit of area ofthe support member; and/or the relative percentage of area occupied bysupport surfaces 60 of cylinders 50 versus the area occupied by the gapsbetween cylinders 50 at the same height of the support surfaces 60. Thedesign of the configuration, i.e., size and shape, of the support memberand its fingers 50 proceeds according to certain requirements.

A basic design requirement pertains to the interface pressure, which isthe pressure exerted on the body of the patient by the supportingsurface area defined by the support surface 60 of each finger 50 of thesupport member. The interface pressure must be kept below the capillaryclosure threshold pressure, which most authorities would agree is 32millimeters of mercury for most patients. Moreover, this thresholdpressure must not be exceeded even when the head section of the bed isarticulated so as to apply maximum pressure in the area supporting thebuttocks of the patient. Thus, the supporting surface area defined bythe support surface 60 of each cylinder 50 must be large enough to keepthe pressure inside each cylinder, and thus the interface pressurebetween the surface of the cylinder and the patient supported thereon,less than 32 millimeters of mercury. The larger the area defined bysupport surface 60 of the cylinder in contact with the second portion ofthe patient's body, the lower is the interface pressure against thepatient's body. The cumulative surface area of the support surfaces 60of the cylinders 50 in contact with the patient's body, depends on thenumber of cylinders per unit of area of the support member and also onthe area of each support surface 60 of the free end of each cylinder 50.The calculation also depends on the anticipated weight (primarily) andheight (secondarily) of the patient to be supported.

There is a trade-off between the area occupied by the gaps betweencylinders 50 in the plane containing support surfaces 60 on the onehand, and the area occupied by support surfaces 60 of the free ends ofcylinders 50 on the other hand. As will become more apparent from thedescription of the invention provided hereafter, large area gaps aredesirable to allow for maximum drainage capability and ease of drainage.However, as noted above, the larger the areas of support surfaces 60 ofcylinders 50, the lower the interface pressure between the body of thepatient and the support surface 60 of the cylinder 50.

In the present invention, the fingers of the support bladder 48, 548 arearrayed in a pattern that can be chosen depending upon manufacturingcriteria, patient support criteria, and the environment in which theapparatus is going to be used. As to the patient support criteria, it isdesirable that the supporting area of the cylinders versus the spacebetween the cylinders have a so-called "support ratio" higher than 1.Thus, a support ratio of 2.33 (70% supporting area versus 30% area ofgaps between the cylinders) is desirable. This permits lower internalpressures inside the cylinders to support a patient of a given weightand body surface area. As shown in FIG. 7 for example, one suitablepattern of arraying cylinders 50 is a hexagonal pattern in which eachcylinder 50 is surrounded by six adjacent cylinders 50. However, aspartially shown in FIG. 5 for example, another suitable pattern includesa square pattern, in which each cylinder 50 is surrounded by fouradjacent cylinders 50. The square pattern results in a lower supportratio, something on the order of 50% of supporting surface and 50% ofspace between the cylinders. In the square pattern, the cylinders 50 arearrayed in straight rows and columns.

Another factor in these design requirements for the cylinders, takesaccount of the degree to which the cylinder buckles under a load, i.e.,the ability of each individual cylinder to be compressed. This designrequirement involves providing each cylinder 50 with sufficient heightso that it can support a very heavy patient without bottoming thepatient against a surface that is not pressure-relieving, i.e., anoninflated surface. As noted above, the support surfaces 60 of thecylinders 50 of the support member are configured to be disposed in acommon plane which is intended to be a horizontal level planeco-terminus with the rest of the patient supporting surfaces 46 of thebed 30 or other patient supporting structure.

As noted above, when the body rests in its neutral plane, the body'smuscular/skeletal system is maintained at equilibrium, i.e., withoutmuscular tension. When the patient's body is being maintained in theneutral plane, it is desirable that the air pressurized cylinders 50 beconfigured so as to be capable of supporting even a heavy patientwithout bottoming any portion of the patient. Thus, the height of thecylinders must be tall enough to accommodate deformation that wouldstill keep the patient's buttocks (the heaviest part of the body)supported by cylinders 50. Desirably, cylinders 50 are configured sothat the largest possible deformation of each cylinder is about 4inches. Accordingly, cylinders 50 of the support member of the presentinvention desirably are at least five inches tall. This allows thecylinders to maintain body alignment and accommodates compressivedeformation of the cylinders without bottoming of the patient againstany noninflated surface which might, underlie the cylinders.

Yet another concern dictating the configuration of the cylinders 50 is atendency for a tall, narrow cross-section cylinder to buckle andtherefore become unstable. Thus, the height of the cylinder should notbe so tall relative to its transverse cross-sectional area, that thecylinder becomes unstable. The ratio of the height of the cylinder tothe diameter of the cross section of the cylinder, defines a usefulparameter known as the "aspect ratio". In the present invention, theaspect ratio is desirably kept very close to one. In an effort to keepthe aspect ratio at about 1 with the height of the cylinder at leastfive inches tall, the diameter of each circular transverse cross-sectioncylinder desirably should be on the order of four inches and preferablyis in a range of from about 4 inches to about 4.5 inches.

Desirably, for patients weighing up to three hundred pounds, the heightof the cylinders 50 of the support member is about five inches, thediameter of the circular transverse cross-sectional area of cylinders 50is somewhere in the range of four inches to four and one-half inches,and the ratio of the area of supporting surfaces 60 of the cylinders 50to the area of the gaps between cylinders is about 70% area of supportsurfaces 60 of cylinders 50 versus 30% area of gaps between cylinders50.

In further accordance with the present invention, means can be providedfor catching the waste from an incontinence event, bathing, woundirrigation, or emergency treatment, of the patient whose body issupported, at least as to a second portion of the patient's body, in thesecond portion supporting means. The catching means desirably issupported by the second portion supporting means and desirably issupported between the second portion of the patient's body and thesecond portion supporting means.

FIGS. 30-33 illustrate a presently preferred embodiment of the catchingmeans in the form of a basin member 562, which is configured to conformsnugly to the configuration of at least the free ends of supportcylinders 550 of the support member 548. Basin member 562 defines aplurality of angularly truncated cylindrical portions 561 that snuglyreceive at least a plurality of at least the free ends 560 and upperportions of support fingers 550 of support bladder 548. The height ofthe basin member should be designed to accommodate a wide range ofvertical body displacement without bottoming, while maintaining properbody alignment.

An alternative embodiment of the catching means desirably includes abasin member 62 shown schematically in FIGS. 1 (phantomed in dashedline), 2, 2A, 3, 4, 9, 17, 18 and 24 for example. Basin member 62 isformed with a configuration similar to basin member 562 except for theadded provision of portions near the periphery to accommodate fill-incylinders 563 of support bladder 548. As shown in FIGS. 2A, 3 and 4 forexample, basin member 62 is configured to conform snugly to theconfiguration of at least the free ends of support cylinders 50 of thesupport member 48. As shown in FIGS. 2 and 2A for example, basin member62 thus defines a plurality of angularly truncated cylindrical portions61, which snugly receive at least a plurality of at least the free endsand upper portions of support fingers 50 of support bladder 48.

Basin member 62, 562 should be formed of material flexible enough sothat basin member 62, 562 offers no substantial impediment to collapsinginto a flat surface when it is desired to deflate support bladder 48 or548 in order to perform a CPR treatment on a rigid support surface.Basin member 62, 562 desirably is formed of liquid impermeable materialsuch as very flexible elastomer which is about 20 mils thickness.Moreover, antimicrobial properties can be built into the basin member byimpregnating antimicrobial material into the material forming basinmember. Desirably, the basin member's upper surface (facing away fromthe lower surface, which receives the cylinders 50 or 550 of the supportmember) is formed of or coated with one or more layers of material thatis hydrophobic and friction-reducing and thus assists in assuringgravity drainage of liquid waste toward one or more drain openings(described below). A suitable coating material contains a blend ofpolyurethane and silicone in the following proportions: 94 grams ofCHEMGLAZE V-300™ moisture cured urethane available from Lord Corp. ofErie, Pa.; 6 grams of CHEMGLAZE 9995™ catalyst available from LordCorp.; and 6 grams of DC-200™ silicone fluid available from Dow CorningCorp. of Midland, Mich.

As shown in FIG. 4 in a cross-sectional view taken at an intermediatecenter line location shown in FIG. 2 by the arrows numbered 4--4 and asshown in FIGS. 2, 2A and 9 for example, basin member 62 is desirablyfurther configured with a floor 64. Floor 64 is disposed beneath thelevel of support surfaces 60 of support fingers 50 when basin member 62is fitted over support bladder 48 such that support fingers 50 arereceived in the conforming truncated cylindrical portions 61 (FIG. 2) ofbasin member 62. In the presently preferred embodiment shown in FIGS.31-33, basin member 562 is similarly configured with a floor 564 that isdisposed beneath the level of support surfaces 560 of support fingers550 when basin member 562 is fitted over support bladder 548 such thatsupport fingers 550 are received in the conforming truncated cylindricalportions 561 of basin member 562.

As shown schematically in FIGS. 1, 2, 4, 9 and 24 for example, basinmember 62 further is desirably configured with at least one drainopening 66 defined through the floor 64. Similarly, as shownschematically in FIGS. 30, 33 and 34 for example, basin member 562further is desirably configured with at least one drain opening 566defined through the floor 564. The slope or height gradient of floor 64,564 is the rate of change of the height of floor 64, 564 as one proceedstoward or away from the respective drain opening 66, 566. The angle atwhich truncated cylindrical portions 61, 561 are joined to therespective floor 64, 564 is determined by the slope or height gradientof the floor. As shown in solid line in FIGS. 4 and 31-33 and in dashedline in FIG. 1 for example, the basin floor is desirably configured witha declining height gradient as one proceeds from the peripheral portionof basin member 62, 562 toward the respective drain opening 66, 566. Thedrain opening is disposed as the lowest height of this declining heightgradient. Thus, in the embodiment shown in FIG. 4 and schematically inFIG. 24 for example, basin member 62 desirably is configured so that ithas a single drain opening 66 at the center and has a floor 64 whichslopes from the peripheral edges toward the center where drain opening66 is located. As shown in FIGS. 31-33 for example, a similarconfiguration is provided for the slope of floor 564 toward drainopening 566.

FIG. 24 schematically represents a top plan view of a rectangularlyshaped basin member 62 for the purpose of illustrating one desirableconfiguration of the slope of floor 64. Four solid straight lines 31emanate from drain opening 66 to divide floor 64 of basin 62 intotriangular-shaped quadrants A, B, C, and D. If basin 62 were disposed ina low air loss bed 30 for example, then floor quadrant A would besituated toward the foot end of bed 30, quadrant C would be disposedtoward the head end of bed 30, and quadrants B and D would be disposedtoward either elongated side of bed 30. Desirably, each floor quadrantslopes downwardly from a horizontal plane toward drain opening 66 at asubstantially constant slope. In one embodiment, the floor 64 inquadrant A has about an 8 degree slope, each of quadrants B and D hasabout a 13 degree slope, and quadrant C has about a 15 degree slope.

In embodiments in which the support member extends the full length of anarticulating supporting structure such as bed 30, one or more additionaldrain openings 66 might need to be provided in the basin member 62because of the bending of the apparatus in accordance with thearticulation of the underlying bed 30. A basin member that were to beconfigured to cover the embodiment of multizone bladder member 48, 548illustrated in FIG. 19 for example, likely would need to be providedwith more than one drain opening 66. Each opening 72 in the FIG. 19embodiment of support bladder 548 would accommodate a separate drainopening 66. Thus, each articulating section desirably would be providedwith its own drain opening 66. In embodiments of the present inventionhaving more than one drain opening 66, each particular drain opening 66will define the localized lowest height of the floor's height gradient,which is constructed to allow gravity to assist movement of wastematerials toward that local drain opening 66.

In a preferred embodiment of the present invention shown in FIG. 18A, aflexible fitting 576 such as a Halkey-Roberts tubing flange, is disposedthrough drain opening 566 of basin member 562, and a rubber cover 577 isbonded over the lip portion of fitting 576 and floor 564 of basin member562. Cover 577 has an opening 539 in registry with an opening 551through fitting 576. A male fitting 578 is provided with a ribbedportion 579 that is removably securable inside flexible fitting 576. Theend of male fitting 578 opposite its ribbed portion 579 is configuredwith externally disposed threads that are securably screwed into theinternally threaded portion of a nut 589. The internal channel of ahollow tubular drain fitting 67 is attached in communication with drainopening 566 of basin member 562 when the end flange 591 of drain fitting67 is carried by nut 589 and a cylindrical portion 63 of drain fittingextends through the opening 553 in the end of nut 589. The end of drainfitting 67 opposite to end flange 591 is connected to one end of wasteremoval conduit 98 by a tie wrap 595 or the like. The female flexiblefitting 76 and mating male fitting are configured to be inserted througha centrally located opening 72 defined through the base 552 of supportbladder 548. As applied to basin member 62 shown in FIGS. 2, 2A, 4, and4A, the drain fitting and its attachments can be configured as describedabove. A drain fitting 67 desirably is disposed to be connected incommunication with each drain opening 66, 566 of basin member 62, 562.

In an alternative embodiment of the present invention shown in FIGS. 17and 18 for example, a drain fitting 67 is disposed through drain opening66 and defines a cylindrical portion 63 which extends from a truncatedconical portion 65. Desirably, truncated conical portion 65 isconfigured with the same angular slope as the slope of floor 64 in thevicinity of drain opening 66. As schematically shown in FIG. 18 forexample, a drain flange 68 defines a cylindrical extension of floor 64of basin member 62 and extends beyond drain opening 66. Desirably, drainflange 68 forms a unitary structure with basin member 62. Drain fitting67 extends into drain opening 66 with the cylindrical portion 63extending down the inside of drain flange 68. A capture fitting 69slides over the outside surface of drain flange 68 and captures drainflange 68 between capture fitting 69 and the exterior of truncatedconical portion 65 of drain fitting 67. Capture fitting 69 is providedwith a land configuration 71, which ensures that the interface 75between the free edge 73 of drain fitting 67 and the lower portion 75 ofbasin floor 64 adjacent drain opening 66 is a smooth interface thatdisallows the pooling of any waste liquids in the vicinity of thisinterface 75. A threaded portion 77 is provided on the exterior surfaceof the cylindrical portion 63 of drain fitting 67 to receive a threadednut 79, which secures capture fitting 69 to the truncated conicalportion 65 of drain fitting 67. The free end 81 of the cylindricalportion 63 of drain fitting 67 is configured to be inserted through acentrally located opening 72 defined through the base 54 of supportbladder 48. As applied to basin member 562 shown in FIGS. 30-34 forexample, the drain fitting and its attachments can be configured asdescribed above.

In an alternative embodiment shown in FIGS. 2 and 3 for example, basinmember 62 defines a plurality of grid configurations 74. Each gridconfiguration 74 is desirably disposed in one of the portions of thebasin member to be located above one of support surfaces 60 of one ofsupport fingers 50 of the support member. Moreover, as shownschematically in FIG. 3 for example, each grid configuration defines alocal exterior topography formed of a plurality of slightly raisedportions 76 separated from one another by recessed channel portions 78.One example of the pattern of each grid configuration 74 includesrectilinear channels 78 and square raised portions 76 as shown forexample in FIG. 3 (where only a sampling of the raised portions andchannels are illustrated to avoid unduly complicating the drawing). Asshown for example in FIG. 2, another grid configuration 74 includeschannels 78 emanating radially from the center point and pie-shapedraised portions 76. Grid configurations 74 are only illustrated on asampling of the upper surfaces of basin member 62 in FIG. 2 in order toavoid unduly complicating this drawing.

The channels 78 of the grid configurations 74 enable a filter sheet(described below) lying atop the basin member to readily transfer thewaste fluids through the filter sheet to the basin member. To accomplishthis purpose most effectively, the transverse width of the channelopenings 78 are sized much larger than the pore size in the filtersheet. Thus, any particulate that was able to pass through the pore sizeof the filter sheet, could not block up the grid configuration channels78 formed in the basin member surface which contacts the filter sheet.

In an alternative embodiment of the support member and the basin memberillustrated in FIG. 4A and partially in FIGS. 20 and 25 for example, thesupport member can include a resilient foam member 448 that iscompletely surrounded by a basin member 462 which is defined by aflexible envelope formed of resilient elastomeric material. Theelastomeric basin member 462 is formed of two mating pieces, a top piece449 and a bottom piece 451. Each of the mating pieces 449, 451 desirablyis formed by dip molding. Top piece 449 of elastomeric basin member 462is desirably heat sealed or sealed with adhesive coating to bottom piece451 at an airtight seam 463. As shown in FIG. 25 for example, top piece449 defines a drain opening 466 from which extends a cylindrical flange468. Bottom piece 451 defines an opening 467 which is configured anddisposed to be in registry with drain opening 466 and the free end offlange 468, which passes through opening 467 and is sealed in airtightfashion along opening 467 to bottom 469 of bottom piece 451. Thus, toppiece 449 and bottom piece 451 are joined to surround and provide anair-tight enclosure for foam member 448. As shown in FIG. 4A forexample, air can be supplied via a fill tube 458 which desirably isprovided in bottom piece 451 of elastomeric basin member 462 and can befitted with a valve 459 at the end thereof.

Top piece 449 is formed with a configuration similar to basin member 62described above, and accordingly defines a plurality of angularlytruncated cylindrical members 461 which are configured similarly toangularly truncated cylindrical members 61. Each angularly truncatedcylindrical member 461 terminates in a substantially flat supportsurface 460 and is connected to an adjacent member 461 by a portion of afloor 464 which slopes toward a local drain opening 466. Desirably, allof the plurality of flat support surfaces 460 are disposed in a commonplane. Each of the support surfaces 460 defines a grid configuration 474which is configured similarly to grid configuration 74 described aboveand coated with a polymer that is both hydrophobic and has a very lowcoefficient of friction.

As embodied herein and shown in FIGS. 4A and 25 for example, foam member448.is configured so that it provides support directly beneath the floor464 of formed in top piece 449 of basin member 462. Foam member 448 hasa top surface 450 that is configured to conform to floor 464 of toppiece 449 of basin member 462. Opposite the top surface 450 of foammember 448 is a substantially flat bottom surface 452, which is receivedin bottom piece 451 of basin member 462.

Foam member 448 desirably is formed of material that is sufficientlypermeable to the flow of air so that air can travel through the foammember itself. However, as shown in FIG. 4A for example, foam member 448also desirably is provided with a plurality of vertically extending airpassages 456. Each passage 456 extends completely through foam member448 from top surface 450 to bottom surface 452. Foam member 448desirably is configured and disposed within elastomeric basin member 462so that each passage 456 is located beneath one of the angularlytruncated cylinders 461 defined in top piece 449 of basin member 462.Moreover, as schematically shown in FIGS. 4A and 20 for example, thebottom surface 452 of the foam member desirably further defines agridwork of horizontally extending grooves 453, which criss-crossthrough the bottom surface 452 and intersect at each opening of eachpassage 456 in bottom surface 452 of foam member 448.

When pressurized air is provided through fill tube 458 in bottom piece451 of the basin member 462, the air flows through the grooves 453 inbottom surface 452 of foam member 448 and rises through each of thevertically extending air passages 456 defined in the foam member. Thepressurized air fills the angularly truncated cylinders 461 defined inthe top piece 449 of the elastomeric member 462. Moreover, the foammember 448 is sufficiently compressible so that the support member canbe compressed by the weight of the patient when the pressurized air isreleased from the elastomeric basin member 462. Furthermore, as shownschematically in FIGS. 20 and 25 for example, foam member 448 furtherdefines a drain opening 470. Cylindrical drain opening flange 468extends through drain opening 470 of foam member 448 before passingthrough opening 467 in bottom piece 451 of basin member 462 and beingsealed to bottom surface 469 of bottom piece 451. Thereafter one of theabove-described embodiments of drain fitting 67 can be passed throughdrain openings 466 and 470 and opening 467 and then secured therein. Forexample, capture fitting 69 and nut 79 can be slipped over and screwedonto cylindrical portion 63 and pinch top piece 449, foam member 448 andbottom piece 451 between conical portion 65 and capture fitting 69.

In yet further accordance with the present invention, the catching meansdesirably includes a liquid permeable filter sheet that is disposed tobe carried above the basin member and closer to the second portion ofthe patient's body than the basin member. As embodied herein and shownin FIGS. 2 and 2A for example, a liquid permeable filter sheet 80 isdisposed to be carried atop basin member 62 by those grid configuration74 sections of basin member 62 which conform to support surfaces 60 ofsupport fingers 50 of the support member. Thus, filter sheet 80 (FIG.2), 580 (FIG. 30) rests atop the flexible basin member that is supportedby the inflated cylinders 50 (FIG. 2), 550 (FIG. 30) of respectivesupport bladder 48 (FIG. 2), 548 (FIG. 30) for example. Filter sheet 80(FIG. 2), 580 (FIG. 30) constitutes a section of the catching means thatis permeable to liquids.

The filter sheet is configured to trap larger solid waste material suchas formed fecal matter and thus acts as a filter to prevent clogging ofthe basin member 62, 562 and drain fitting 67 (and other conduitsdescribed hereafter for transferring waste material). As embodied hereinand shown in FIGS. 2 and 30, filter sheet 80, 580 defines fabric havinga plurality of small individual pores 82 between the threads 84 formingthe filter sheet 80, 580. The sizes of pores 82 are desirably very smallso that there is a large number of them per unit of area of filter sheet80, 580 but not so small as to prevent rapid draining of liquids throughthe pores. Pores 82 render filter sheet 80, 580 liquid permeable byallowing fluids to pass readily through filter sheet 80, 580 to floor64, 564 of basin member 62, 562. However, pores 82 are small enough toprevent passage of larger solid waste that otherwise might become lodgedin the flexible basin member 62, 562 or drain fitting 67 or wasteremoval conduit 98. The liquid permeable portion of filter sheet 80, 580containing pores 82 can be formed of woven material or spun bondcontinuous fibers, as desired.

In a presently preferred embodiment of the filter sheet 580 shown inFIG. 30, a plurality of auxiliary drainage holes 585 can be definedthrough filter sheet 580. Such drainage holes 585 may be cut asunfinished holes with a laser or with a water jet and have diameters onthe order of 0.16" and be uniformly spaced apart by about 1.25 inchesbetween centers of adjacent holes in each of a pattern of rectanglesmeasuring 1.25 inches by 2.5 inches. The two patterns of rectanglesoverlap one another such that the corner of a rectangle from one patternis disposed at the center of a rectangle from the other pattern. Inaddition to the center panel formed of woven material or spun bondcontinuous fibers with pores 82 and the superimposed patterned sectioncontaining drainage holes 585, filter sheet 580 is provided with a sidepanel 586 disposed to each side of the center panel. Each side panel 586is desirably joined to a side edge of the center panel by a flat felledseam 588 sometimes known as a Calderson seam. Each side panel 586 isdesirably formed of a textile fabric composed of 50% cotton and 50%polyester fibers.

In operation, filter sheet 580, 80 performs the function of a draw sheetwhich also allows free flow of fluids away from the patient and into thebasin member of the waste managing means. Thus, the material forming thefilter sheet should have a very high tensile strength that is at leastequal to the tensile strength of current hospital draw sheets. Thematerial forming the filter sheet also should have a very smallcoefficient of friction, small enough so that it is equal to or lessthan the coefficient of friction of a material such as HY.TEX™ fabric,which is available from Consoltex of Montreal, Canada. This smallcoefficient of friction facilitates use of the filter sheet when it isfunctioning as a draw sheet. The filter sheet should be capable ofwithstanding multiple washings and should be formed of material that inaddition to being antimicrobial, is also bacteriostatic, hypoallergenic,flame retardant, odor resistant, and sufficiently hydrophobic so as todry quickly. The filter sheet should be formed of material that is stainresistant for repeated use in an environment that anticipates stainingfrom urine, from fecal matter, and from fluids normally used in thehospital environment. At least the liquid permeable center panel portionof a suitable filter sheet 80, 580 is desirably formed of a monofilamentplastic such as nylon or polyester filter mesh fabric of 114 pick.Antimicrobial properties can be built into the filter sheet. Forexample, antimicrobial material could be impregnated into the plasticmaterial forming the filter sheet.

In an alternative embodiment shown in FIG. 2, filter sheet 80 hasreinforced edges 86 forming a continuous border around the portioncontaining small pores 82. As shown in FIG. 2 for example, reinforcedopenings 87 desirably are formed in border portions 86 on opposite sidesof filter sheet 80 and configured to accommodate the hands of anoperator to facilitate the draw sheet function. In a further alternativeembodiment shown partially in FIGS. 2 and 2A for example, filter sheet80 can be provided with handles or grips 88, which can be secured to theexterior surfaces of opposite border portions 86 of filter sheet 80 bysuch conventional means as sewing, rivets, adhesives, velcro, and thelike.

In accordance with the present invention, a means can be provided fordetachably securing the filter sheet against movement away from aposition resting over the basin member. However, the detachably securingmeans also should enable the hospital staff to release the filter sheetfrom its secured position by the use of only a small amount of manualeffort. The filter sheet's detachably securing means desirably can beprovided in the form of mechanical fastening means such as matinghook-and-loop substrates and/or mating snaps. As embodied herein andschematically shown in FIGS. 30-32 for example, each side panel offilter sheet 580 is provided with an elongated strip of hook-and-loopfastener substrate 581 disposed horizontally along the exterior surfaceof filter sheet 580. As shown in FIG. 30, a side attachment panel 523has one end fitted with an elongated strip of hook-and-loop fastenersubstrate 582 disposed vertically along the interior surface of panel523. Three other similar side attachment panels 523 are provided so thateach of their vertically disposed hook-and-loop substrates 582 ispositioned to engage a corresponding horizontally disposed portion ofhook-and-loop substrate 581 carried near the edges of the opposite sidepanels of filter sheet 580. The crossing disposition of verticalsubstrates 582 relative to the corresponding horizontal substrates 581ensures that filter sheet 580 can be secured without requiring perfectalignment of the ends of the filter sheet with respect to the ends ofthe four side attachment panels 523. The substrates 581, 582 engage oneanother to hold filter sheet 580 in place, yet permit easy disengagementof filter sheet 580 whenever use of filter sheet 580 as a draw sheet isdesired.

Moreover, as shown in FIG. 32, the inside surface of each sideattachment panel 523 is provided with a plurality of snaps 536, whichare mateable with a second plurality of snaps 521 mounted on theexterior endwall surfaces of the half-height turning cushions 510forming an adaptor shell 528 (described hereafter). Similarly, as shownin FIG. 30, the inside surface of each side attachment panel 522 isprovided with a plurality of snaps 536, which are detachably attachableto a plurality of mating snaps 521 disposed on the exterior endwallsurfaces of the slotted cushions 509 and half-height turning cushions510 forming adaptor shell 528 (described hereafter).

In an alternative embodiment schematically shown in FIGS. 2 and 2A forexample, a means for detachably securing the filter sheet includes aplurality of snaps 90 which is mateable with a second plurality of snaps92 mounted on the exterior surfaces of side panels 94, which arethemselves attached to the exterior endwall surfaces 238 of an adaptorshell 228 (described hereafter). The fastening end of filter sheet snaps90 desirably can be exposed for service on the interior surface ofborder portions 86 of filter sheet 80. As shown in FIG. 2A for example,filter sheet snaps 90 attach to panel snaps 92 mounted on the outsidesurfaces of side panels 94. The snaps 90, 92 engage one another to holdfilter sheet 80 in place, yet permit easy disengagement of filter sheet80 by grasping reinforced openings 87 or handles 88 and pulling awayfrom the adaptor shell whenever use of filter sheet 80 as a draw sheetis desired.

Moreover, as shown in FIGS. 2 and 2A for the alternative embodiment, theinside surfaces of side panels 94 are provided with a plurality of snaps96, which are detachably attachable to a plurality of mating snaps 97disposed on the peripheral walls 238 of legs 236 (described hereafter)of air inflated cushions 234 (described hereafter) or on the endwalls ofair sacks 44 or on the endwalls of turning sacks 270 (describedhereafter). Each corresponding pair of snaps 96, 97 engages one anotherthrough an attachment opening 83 defined through a side flap portion 85of basin member 62 and thereby attaches basin member 62 to an adaptorshell 228 (described hereafter).

In still further accordance with the present invention, a means can beprovided for removing the waste materials that are caught by thecatching means. The waste removing means is configured and disposed soas to be in communication with the catching means. As embodied hereinand shown in FIGS. 1, 2 and 9 for example, the waste removing meansdesirably includes at least one waste removal conduit 98. Waste removalconduit 98 preferably is formed of polyvinyl chloride (PVC) flexibletubing that desirably is sized with a three-quarter inch interiordiameter and a circular transverse cross-section. As shown in FIG. 2 forexample, waste removal conduit 98 has one end configured to be connectedin communication with at least one drain opening 66 (or 566, FIG. 30) ofbasin member 62 (or 562, FIG. 30). Desirably, waste removal conduit 98is disposed so as to be connected to the free end of cylindrical portion63 (FIGS. 17, 18 and 18A) of drain fitting 67. Waste removal conduit 98is configured to be easily attachable and detachable from drain fitting67 for ease of cleaning and servicing. As embodied herein and shown inFIG. 9 for example, free end 81 of drain fitting 67 desirably fitsinside one end of waste removal conduit 98 and is secured therein by aconventional band hose clamp 70, such as might be used to secure theradiator hose of an automobile. As schematically shown in FIG. 9 forexample, waste removal conduit 98 desirably is vertically disposed inorder to take advantage of the assistance provided by the force ofgravity and is configured so as to provide a straight path that does notcontain any steps or shelves where waste might accumulate.

As embodied herein and shown schematically in FIG. 9 for example, theremoving means also desirably includes a holding reservoir 100 connectedin communication with the opposite end of waste removal conduit 98.Holding reservoir 100 defines a liquid impermeable plenum whichdesirably has a capacity of one to two gallons.

As embodied herein and shown schematically in FIG. 9 for example, theremoving means can further include a vacuum blower 102 that isconfigured and disposed so that it can create a suction force in atleast the catching means and waste removal conduit 98. As shownschematically in FIGS. 9 and 49D for example, vacuum blower 102 isconnected via a conduit 132 in communication with holding reservoir 100,which enables vacuum blower 102 to communicate indirectly with wasteremoval conduit 98 connected in communication with holding reservoir 100via a removal conduit extension 99 and a flow diverter valve 108(described below).

In further accordance with the present invention, the removing meanspreferably includes a means for separating the liquid from the air inthe fluid that is removed from the catching means. As embodied hereinand shown schematically in FIGS. 49A, 49B, 49C, 49D, the separatingmeans preferably includes a separator tube 555 that is disposed so thatthe waste removal conduit 98 communicates with the holding reservoir 100via vacuum flow diverter valve 108 (described below) and separator tube555. As shown in FIGS. 49A and 49B, the inlet end of separator tube 555is configured with ribs which become inserted inside removal conduitextension 99 and engage same. Separator tube 555 desirably is configuredwith a 180° curved portion that is disposed in the path of the wastefluid (indicated in FIGS. 49A-49D by dashed arrows for gas and solidarrows for liquid) that exits the waste removal conduit and before thefluid enters holding reservoir 100. At the end of the separator tubeopposite the inlet end, there is a blind end of the separator tube. Thecurved portion of the separator tube is disposed between the inlet endand the blind end and is disposed inside the holding reservoir alongwith the blind end of the separator tube. The bottom portion of theblind end of separator tube is configured with a slot 556 which opens ina direction that points generally downwardly toward the bottom of theholding reservoir 100. In operation, as the waste fluid travels insideseparator tube 555 around the curved portion and toward the blind end,centrifugal force separates the liquid from the air and directs theliquid out of the tube through the slot 556 and toward the bottom of theholding reservoir. A liquid outlet opening 198 is provided near thebottom of reservoir 100 and communicates with a liquid outlet tubefixture 557. As schematically shown in FIG. 49D for example, the freeend of liquid outlet tube fixture 557 is configured to communicate withthe inlet of a waste pump 194 (described below). As schematically shownin FIGS. 49A for example, an air outlet 558 is provided near the top ofreservoir 100. Air outlet 558 communicates with an air outlet tubefixture 559 via a vacuum slide valve 596. The free end of air outlettube fixture 559 is configured to engage a vacuum conduit 132, whichleads between reservoir 100 and vacuum blower 102. Vacuum slide valve596 can be adjusted to regulate the flow of air from reservoir 100 tovacuum blower 102. In addition, a check valve can be provided insidereservoir 100 to prevent the level of waste inside reservoir 100 fromrising to a level from which entry into vacuum blower 102 could beeffected. As shown in FIGS. 49A, 49B, and 49C, the check valve caninclude a hollow sphere 597. A pair of vertically extending rails 598 isdisposed to confine the sphere 597 adjacent a corner of the reservoir100 so that the sphere is only free to move in a vertical path within aspace defined by the corner of reservoir 100 and the two rails 598. Asshown schematically in FIGS. 49A and 49C for example, as the level ofliquid rises within reservoir, sphere 597 floats until its proximity toair outlet 558 and the suction provided by vacuum blower 102 causessphere 597 into air outlet 558 to seal same. In addition, a threadedopening formed through the wall of reservoir 100 is sealed by aremovable threaded plug 599 so that a service technician can obtainaccess to the inside of reservoir 100 for cleaning.

In accordance with the present invention, the vacuum blower operatesessentially continuously at a relatively low speed for the purpose ofproviding air flowing beneath the occupant of the waste managementsystem. The constant removal of air from beneath the occupant assists inthe control of odor and moisture beneath the occupant. Vacuum blower 102preferably can be run at a relatively higher speed, which has amagnitude that depends on the configuration of the other parameters ofthe waste management system but must be adequate to provide the suctionforce for removing waste materials. Desirably, vacuum blower 102 isdesigned to run at a maximum throughput of 27 cubic feet per minute at avacuum pressure of 40 inches of water and is powered by a one phase, onehorsepower motor operating from a 110 volt 60 cycle alternating currentpower source.

In an alternative embodiment, vacuum blower 102 can be set up so that itonly runs when waste liquids are to be removed. In this alternativeembodiment, vacuum blower is provided with two operational speeds, arelatively low speed and a relatively high speed. The exact speeds willdepend on the configuration of the other parameters of the wastemanagement system. The higher speed provides the suction force forremoving waste materials when the vacuum wand 104 (described hereafter)is in use, and the lower speed provides vacuum force when an eventoccurs that produces liquid which has been detected by the moisturedetection means (described hereafter). Selection of the higher or lowerspeed in this alternative embodiment of vacuum blower 102 desirably isdetermined by a controller 164. A suitable controller 164 can beprovided by an array of relays programmed in an appropriate logiccircuit, but desirably is provided by a suitably programmed 8051 seriesmicroprocessor.

In still further accordance with the present invention, the removingmeans also can include a portable, manually directed suction device. Asembodied herein and shown schematically in FIGS. 1, 9-11, 35 and 40 forexample, a suitable portable, manually directed suction device can beprovided in the form of a vacuum wand generally designated by thenumeral 104. The free end of o vacuum wand 104 can be a tip 112 formedof a rigid plastic material in the shape of a flattened horn.Alternatively, a soft, flexible, and smooth plastic material can be usedto form tip 112. A friction fit mechanical connection between tip 112and wand 104 permits manual detachment of tip 112 from wand 104. In someembodiments, tip 112 can be disposable. Moreover, as shown schematicallyin FIG. 9 for example, suction force is provided to tip 112 of vacuumwand 104 by connecting same via a suction line 106 and a flow divertervalve 108 (described below) in communication with holding reservoir 100and vacuum blower 102.

As shown schematically in FIGS. 1, 9-11 and 40 for example, suction line106, which connects vacuum wand 104 to holding reservoir 100 (FIG. 9),is desirably formed of flexible plastic, which desirably is reinforcedby plastic spiraling 110 (FIG. 11) formed in a corrugated helix patternin the outside of line 106 in order to prevent kinking of the suctionline, especially when waste is being vacuumed. A suitable suction line106 is provided by a 6.5 foot length of flexible three-quarter inchinternal diameter PVC 50 durometer tubing with a rigid PVC helix andwith a bend radius of 1.5 inches.

A preferred embodiment of flow diverter valve 108 is shown in FIGS.45-47, and an alternative embodiment is shown in FIGS. 21 and 22. In thedescription which follows, some of the like-functioning components willbe referenced with the same designating numerals. Accordingly, asembodied herein and shown schematically in FIGS. 9, 22 and 45-47 forexample, flow diverter valve 108 desirably has three ports 801, 802,803. Port 801 is connected to vacuum wand 104 via suction line 106. Port802 is connected to holding tank 100 via extension 99 of waste removalconduit 98. Port 803 is connected in communication with basin member 62,562 via waste removal conduit 98 and drain fitting 67. Vacuum flowdiverter valve 108 includes a valve motor 804, a valve body 805, and avalve spool 806, Diverter valve 108 can be configured in one of two flowpaths by operation of electric motor 804. As shown in FIG. 45, motor 804is controlled by controller 164 via a motor control PC board 704 mountedon the housing 815 for valve body 805. Hall effect sensors 705 mountedon valve body 805 determine the position of the flow diverter valvespool 806 by detecting when a magnet 706 mounted in spool 806 becomesdisposed in proximity of the sensors 705. As schematically shown in FIG.45, sensors 705 and motor 804 are connected to motor control pc board704. The motor control board 704 is electrically connected to the maincontroller 164 via a cable 105. As shown in FIG. 46, motor 804 isconnected to spool 806 by means of a drive pin 810 and collar 811mounted on the motor shaft 812 and inserted into a slot 814 on spool806.

Similarly, the alternative embodiment of vacuum flow diverter valve 108shown in FIGS. 21 and 22, includes a valve body 805, a valve spool 806,a slip clutch hub 807, a pair of spring-biased ball plungers, and anelectric motor 804, which is controlled by controller 164. Each springball plunger includes a spheroidal member 808 mounted at the end of acoiled spring 809 which biases the spheroid 808 into a semi-sphericalcavity defined in slip clutch hub 807.

Operation of motor 804 rotates valve spool 806 between a first positionand a second position. In a first position, which is schematically shownin FIGS. 22 and 46-47 for example, diverter valve 108 provides a flowpath in which each of basin 62, 562, holding reservoir 100, suction line106 of vacuum wand 104, and vacuum blower 102 are connected incommunication with one another. This first position of diverter valve108 thus disposes vacuum blower 102 so as to be able to create a suctionforce at tip 112 at the free end of vacuum wand 104 as well as arelatively smaller suction force at basin member 62, 562. In this firstposition with the blower described above, roughly 20 cubic feet perminute (CFM) suction flow is applied to vacuum wand 104 and 10 CFM isapplied to basin member 62, 562. In a second position, which is notshown in the Figs., diverter valve 108 provides a flow path in whicheach of basin 62 (or 562), holding reservoir 100, and vacuum blower 102are connected in communication with one another. This second position ofdiverter valve 108 thus disposes vacuum blower 102 so as to be able tocreate a suction force that removes waste from basin 62, 562 and pullsthis removed waste into holding reservoir 100 without providing anysuction force to vacuum wand 104. Moreover, since orientation ofdiverter valve 108 to assume the first position, divides the,suctionprovided by vacuum blower 102 between two paths, the suction forceprovided to vacuum wand 104 in the first position of diverter valve 108is desirably greater than the suction force provided to basin 62, 562alone when diverter valve 108 assumes the second position. To achievethis greater suction, controller 164 is programmed to operate vacuumblower 102 at high speed when diverter valve 108 is configured in thefirst position and at the continuously running low speed when thediverter valve 108 is configured in the second position.

Desirably, the suction provided by vacuum wand 104 is intended to removeliquid waste such as urine and rinse solution, viscous waste such asrunning stool or loose stool, and solid waste that does not exceed theopening size of the vacuum tip 112. Desirably, the opening size ofvacuum tip 112 is 0.4 inches wide by 2.5 inches long at the free end.However, at the attachment (or throat) end of tip 112, the length of theopening of tip 112 reduces to about 0.7 inch. Thus, larger solid waste,such as larger formed fecal matter, will not be able to be vacuumeddirectly with wand 104. In order to be vacuumed, the larger formed wastemust first be eroded by a rinse spray into a semi-liquid condition. Themaximum size fecal matter able to be suctioned in the configuration ofthe vacuum blower and tubing described above, is approximately 0.4inches.

Moreover, as shown schematically in FIGS. 9 and 11 for example, theprovision of a plurality of safety louvers 116 at the underside surfaceof the free end of tip 112 is designed so that suction can be appliedvia tip 112 to suck off rinse solution, other fluids, and smallparticulates from the filter sheet 80. Safety louvers 116 also providevacuum reduction, splash back protection from liquid spray impinging onthe filter sheet 80, and lubrication of the inside of the vacuum tipwith liquids, such as rinse solution (explained more fully hereafter)sucked into vacuum tip 112 through louvers 116 to help prevent stickingof fecal matter inside the vacuum tip.

Desirably, vacuum wand 104 can be maneuverable with one hand. As shownschematically in FIGS. 1, 11 and 35 for example, vacuum wand 104desirably is provided with a pistol grip 118 and has an activationmechanism by which the user's thumb can turn the suction on and offwhile holding the wand in one hand. In a presently preferred embodimentshown in FIG. 35, an "on" suction switch 520 and an "off" suction switch521 are provided by which the user's thumb can turn the suction on andoff. Suction switches 520, 521 are electrical switches by which theoperator can control the configuration of diverter valve 108 (FIGS. 9,21, 22, and 45-47) either to provide suction to or deprive suction from,vacuum wand 104. The "on" suction switch 520 transmits an electricalsignal to controller 164, which responds to this electrical signal bysending a control signal via a cable 105 so that motor 804 configuresflow diverter valve 108 in the first position, which connects vacuumblower 102 in a manner that provides a suction force to remove wastefrom tip 112 of vacuum wand 104 and basin 62, 562 and transports thisremoved waste into holding reservoir 100 (FIG. 9). The "off" suctionswitch 521 transmits an electrical signal to controller 164, whichresponds to this electrical signal by sending a control signal via acable 105 so that motor-operated flow diverter valve 108 configuresitself to assume the second position, which connects vacuum blower 102in a manner that deprives vacuum wand 104 from receiving a suction forcegenerated by vacuum blower 102 and the continuously running lower amountof suction is applied to basin 62, 562 from blower 102.

In further accordance with the present invention, a means can beprovided for controlling operation of the vacuum blower in response toactivation of the vacuum wand. As embodied herein, the vacuum blowercontrol means can include controller 164 that can be programmed toactivate vacuum blower 102 to a higher speed (than the blower's normalcontinuous running speed) upon receipt of a signal from the activationswitch 520 for operating vacuum wand 104 in a suction mode uponconfiguring vacuum flow diverter valve 108 so that wand 104 communicateswith vacuum blower 102. At the higher speed, the vacuum blower providessufficient suction to both vacuum wand 104 and to waste removal conduit98 to move waste fluid out of basin member 562, 62 and into holdingreservoir 100.

In an alternative embodiment of vacuum wand 104 shown in FIGS. 9 and 11,an "on/off" suction switch 120 is provided as a pneumatic switch whichlacks any electrical components. As schematically shown in FIG. 11,suction switch 120 can include a small flexible bladder 121 connected incommunication with a pneumatic line 122. Pneumatic line 122 desirably isa length of one sixteenth inch internal diameter PVC TYGON™ tubing.Actuation of suction switch 120 occurs when the operator's thumb appliespressure to suction switch 120 which squeezes bladder 121. When thebladder 121 is squeezed, a signal in the form of a pressure pulsetravels via pneumatic line 122 to a pressure transducer 124 (FIG. 9),which is disposed at a location that is remote from wand 104 in order toeliminate electrical components from wand 104. Pressure transducer 24converts this pressure signal into an electrical signal. Asschematically shown in FIG. 9 for example, pressure transducer 124 isconnected to controller 164.

Upon receipt of the pressure pulse from bladder 121, transducer 124sends an electrical signal to controller 164, which responds to thiselectrical signal by sending a control signal via a cable 105 so thatmotor-operated flow diverter valve 108 configures itself to connectvacuum blower 102 in a manner that provides a suction force to removewaste from tip 112 of vacuum wand 104 and basin 62 and transports thisremoved waste into holding reservoir 100 (FIG. 9). In the alternativeembodiment with on/off two-speed vacuum blower operation, anothercontrol signal would be sent via a cable 224 to operate vacuum blower102 at the higher speed. These two control signals result in theprovision of suction in suction line 106 and moderate suction in wasteremoval conduit 98.

When the operator of the alternative embodiment wants to discontinuesuction through wand 104, the operator presses bladder switch 120 (FIG.11). Another pressure signal is transmitted via pneumatic line 122 tocontroller 164 via pressure transducer 124, and controller 164 isprogrammed to send a time-delayed control signal via cable 105 so thatflow diverter valve 108 reorients itself to a configuration that removessuction from vacuum wand 104 and applies the normal amount of suction tobasin 62 from blower 102. In the alternative embodiment with on/offtwo-speed vacuum blower operation, controller 164 is programmed toreturn vacuum blower 102 to low speed operation beginning about 20seconds after flow diverter valve 108 removes suction from line 106.

In further accordance with the present invention, a means can beprovided to prevent operation of the vacuum blower from drawing wastesout of the removing means and backing same into the vacuum blowerconduits which enable the vacuum blower to communicate with the interiorof the holding reservoir. The latter contamination is undesirable, as itcould lead to the introduction of undesirable liquids, particulates, andgasses into the vacuum blower 102 and possibly into the patientenvironment. For example, the liquids and particulates could hinderoperation of the blower or damage the blower. As embodied herein andshown schematically in FIG. 49A for example, the means for preventingwaste back-up into the vacuum blower conduits, desirably includes a highlevel liquid sensor 507 connected via an electric cable 409 incommunication with controller 164, which in turn is connected (see FIG.9 for example) so as to be able to control operation of vacuum blower102. Liquid level sensor 507 is disposed so as to be able to detectliquid at a level-within holding reservoir that is just below where thevacuum conduit 132, which leads between reservoir 100 and blower 102,enters holding reservoir 100. When sensor 507 detects liquid at thislevel, sensor 507 sends a liquid detection signal in the form of anelectrical signal via cable 133 to controller 164. Controller 164 ispreprogrammed so that upon receipt of this liquid detection signal fromsensor 507, controller 164 deactivates operation of vacuum blower 102.In this way, controller 164 prevents operation of vacuum blower 102 whenthe waste level sensor 507 detects that holding reservoir 100 has becomefilled to a predetermined proportion of its capacity. The deactivationof vacuum blower 102 prevents suction from waste removal conduit 98and/or a vacuum wand 104 from attempting to introduce additional wastesinto a holding reservoir 100 which is nearing its capacity and thusdisposing waste liquids very near to the entrance of the vacuum conduit132 which leads to vacuum blower 102. The liquid level sensor 507preferably is a capacitive proximity level sensor configured asschematically shown in FIGS. 42 and 42A for example and described belowin connection with the liquid level sensor provided for rinse jug 142.

In further accordance with the present invention, the removing means caninclude means for controlling odor. As embodied herein and shownschematically in FIG. 9 for example, the odor control means can includea housing in the form of a cannister 136 containing an odor filter 138such as activated carbon. Cannister 136 can be disposed in the conduit132 that connects vacuum blower 102 to holding reservoir 100. As shownin FIG. 9 for example, vacuum blower 102 preferably can be disposedbetween cannister 136 and holding reservoir 100 so that vacuum blower102 exhausts to atmosphere via the odor control means. Alternatively,cannister 136 can be disposed between the vacuum blower 102 and holdingreservoir 100. In this latter configuration, the vacuum blowercommunicates with the holding reservoir via the odor control means. Asuitable cannister 136 can be formed of rigid plastic or metal materialcapable of containing 2.3 pounds of activated charcoal and having aremovable cover 140 to permit servicing of the odor control material andreplacement of same at appropriate time intervals.

In yet further accordance with the present invention, the removing meanscan include means for cleansing. The cleansing means desirably providesa spray of a liquid that can be used to rinse,.cleanse, disinfect, woundirrigate or the like. The cleansing means desirably can be directed andoperated by one hand of the operator. The cleansing means desirablyprovides the liquid spray in a controlled manner so that the spray willnot be likely to cause skin trauma to the patient being cleansed norundue splashing from the surface being cleansed, yet provides sufficientpressure for effective cleansing action of the surface targeted forcleansing.

As embodied herein and shown in FIGS. 6, 26, 28, 29B and 38 for example,the cleansing means can include a rinse solution container 142 in theform of a rinse jug 142 having a handle 144 defined in the front endwall145 of jug 142. Jug 142 desirably can be formed of liquid impermeablematerial such as high density polyethylene (HDPE), or polypropylene, orpolycarbonate, or any similar rigid plastic material. Depending on theembodiment, the rinse solution container can be configured to beremovably securable to the patient support apparatus (FIG. 1) or to aservice cart 256 (FIGS. 12, 12A, 15 and 16 for examples). Rinse solutioncontainer 142 can be provided with a capacity of 3 liters and can befilled with various rinse solutions such as tap water, saline rinse,PERI-WASH™ solution, and the like, via a fill opening 149 which isdefined at the free end of a circularly cylindrical annular member 151.Annular member 151 has an exterior surface which can be provided withscrew threads so that fill opening 149 is removably sealable by means ofa screw-on threaded cap. As schematically shown in FIG. 26 for example,rinse jug 142 includes a siphon tube 146 (shown in phantom by the dashedlines) having an open mouth disposed near the bottom of jug 142 and anopposite end connected to an inlet/outlet valve 148 defined in orattached to the upper portion of the back endwall 147 of jug 142.

As shown schematically in FIG. 26, a check valve 587 is disposed insiphon tube 146 at or near the open mouth of siphon tube 146. Checkvalve 587 allows liquid to flow from rinse jug 142 into siphon tube 146and out of inlet/outlet valve 148, but prevents liquid from flowing pastcheck valve 587 and leaving siphon 146 to return to rinse jug 142. Bypreventing liquid from draining out of rinse liquid supply conduits 126,check valve 587 keeps rinse liquid supply conduits 126 full and thusprovides means for on-demand supply of rinse liquid to nozzle 152 ofvacuum wand 104.

As embodied herein and shown in FIGS. 9, 11 and 26 for example, thecleansing means also can include a rinse solution conduit 126 having afree end carried by vacuum wand 104 and an opposite end connected so asto be in communication with valve 148 (FIG. 26) and siphon 146 of rinsesolution container 142. A suitable tubing for rinse solution conduit 126is provided by 0.170 inch internal diameter PVC TYGON™ tubing.Desirably, as shown in FIG. 9 for example, rinse solution conduit 126 isdisposed within suction line 106. As shown in FIG. 11 for example, oneend of conduit 126 exits a portion of line 106 disposed within theinterior of vacuum wand 104. The opposite end of conduit 126 exits theportion of line 106 that is in the vicinity of where line 106 becomesconnected to port 803 of flow diverter valve 108.

As embodied herein and shown schematically in FIGS. 9, 11 and 35 forexample, the cleansing means can include a rinse spray nozzle 152, whichdesirably can be provided on vacuum wand 104. Rinse spray nozzle 152desirably is connected in communication with the free end of rinsesolution conduit 126 and is configured to produce a fan-shaped pattern(FIG. 11) of rinse liquid 154. As schematically shown in FIG. 11 forexample, rinse spray nozzle 152 desirably is disposed on wand 104 andconfigured so that this fan-shaped pattern of rinse solution 154 isdirected to contact a site 155 on the target surface, such as filtersheet 80, just behind louvers 116 on vacuum tip 112. In this way, thevacuum force (schematically indicated by the arrows 157 inside tip 112in FIG. 11) applied at the free edge of tip 112 pulls liquids throughlouvers 116 and reduces the amount of liquids that can collect at thetarget site 155 of the rinse liquid spray and be splashed by the sprayof rinse liquid 154. As shown in FIGS. 11 and 35 for example, rinsespray nozzle 152 desirably is configured so that it does not come intocontact with vacuum wand suction tip 112, and this assists in theprevention of contamination or soilage. However, in some embodiments,nozzle 152 may be both removable and disposable.

In addition, the cleansing means forming a part of the removing meanscan further include a rinse pump. As shown schematically in FIGS. 9 and38 for example, a rinse pump 150 desirably is connected so as to be ableto pump rinse solution from rinse solution container 142 through rinsesolution conduit 126. A suitable rinse pump 150 is provided by a 2 inchbellows pump designed to flow 0.3 gallons per minute at 20 psi andpowered by a 120 volt AC 60 cycle one phase electric motor. Liquid flowrates of rinse fluid are controlled by operation of rinse pump 150 to beat a safe velocity and pressure that will not debride open wounds orcause any skin trauma. Desirably, the pressure of the rinse solutionshould not be so great as to apply a dynamic impact pressure exceeding 8psi on the patient's skin. The velocities and pressures of the rinseliquid provided by rinse pump 150 are nonetheless adequate to cleanwaste from the patient and filter sheet 80. Desirably, the rinsesolution flow rates will be low enough to minimize or prevent splashing.

In further accordance with the present invention, a means is providedfor protecting the operator against contact with back-splash that mightoccur when using the cleansing means. As embodied herein and shown inFIGS. 35, 38, and 40 (phantom), the splash protection means desirablyincludes a splash guard 501 which is configured in the form of afan-shaped member. Splash guard 501 desirably is formed of a semi-rigid,clear plastic material such as clear PVC. As shown in FIG. 35, thesplash protection means also desirably includes a clip-on shield holder502 that is manually attachable and removable from vacuum wand 104.Holder 502 has a semicircular collar member 503 that forms afriction-fit with a groove (not visible in the view shown in FIG. 35)formed in the vicinity of the base of tip 112. Splash guard 501 can befriction-fit into a slot (not visible in the view shown in FIG. 35)formed in a forward projecting flange 504 of holder 502 or can beintegrally formed as a unitary structure with holder 502. A gripping web505 connects flange 504 to collar 503 and carries ribs 506 which provideconvenient sizes for the operator's fingers to grasp when manipulatingholder 502 for clip-on attachment to or detachment from wand 104.

As shown schematically in FIGS. 1, 10 and 40 for example, vacuum wand104 (without tip 112) and its associated suction line 106 desirably arestored when not in use. In the presently preferred embodiment shown inFIG. 40, access to storage compartment 111 desirably can be provided viaa sliding drawer 515 that slides into and out of storage compartment111, which receives line 106 loosely coiled therein. After use of wand104, the soiled tip 112 is discarded before the wand is stored instorage compartment 111, which is desirably provided at the footboard113 of the bed 30. In alternative embodiments, a similar storagecompartment can be provided as part of a service cart 256 (FIGS. 12,12A, 15 and 16 for examples). In an alternative embodiment shownschematically in FIG. 10 for example, suction line 106 can be secured instorage compartment 111 by friction fit between a plurality of pairs ofopposed guide members 240 disposed in door 115 in a pattern thatdetermines the wrap direction of line 106. In a further alternativeembodiment, instead of the posts shown in FIG. 10 for guide members 240,the guide members desirably are configured as molded recesses whichextend around the floor of door 115 and are shaped to receive thecylindrical tubing of suction line 106.

In a preferred embodiment schematically illustrated in FIGS. 11 and 35for example, the cleansing means can include a trigger-type rinsecontrol valve that provides rinse solution to rinse spray nozzle 152.The rinse control valve desirably is a valve which can be operatedmechanically to allow rinse solution, which is provided under pressureby pump 150 from rinse solution container 142 to conduit 126, to bedispensed through nozzle 152. Desirably, the rinse control valveincludes a lever switch 156 pivotable about a pin 157 on the hand heldportion of vacuum wand 104 and is spring-biased to crimp conduit 126 andprevent flow of rinse liquid to nozzle 152. Manual squeezing of trigger156 toward pistol grip 118 works against the spring to uncrimp conduit126 and provide rinse solution to nozzle 152.

In accordance with the present invention, a means is provided so thatthe rinse pump automatically provides rinse solution to the vacuum wandwhenever the vacuum wand is going to be used by the operator. Asembodied herein, the automatic activation means for the rinse pump caninclude a pressure switch and an accumulator disposed in the rinsesolution conduit. As shown in FIG. 38, a pressure switch 583 is providedto measure the pressure in a branch 572 of the rinse liquid conduit thatsupplies rinse liquid to rinse nozzle 152 of vacuum wand 104. Pressureswitch 583 is set so that upon detecting a pressure of a first or lowerpreset amount, such as about 12 psi, switch 583 provides a signal tocontroller 164, which is programmed to turn on rinse pump 150 uponreceipt of this signal from pressure switch 583. Upon detecting apressure of a second higher preset amount, such as about 17 psi, switch583 signals controller 164, and controller 164 turns off rinse pump 150in response to this signal of pressure switch 583 indicative of thehigher detected pressure in branch 572.

Moreover, as schematically shown in FIG. 38, an in-line accumulator 584is provided in rinse solution conduit 126 in the form of an elasticbellows. When rinse pump 150 is operating, rinse solution fillsaccumulator 584 until the pressure in branch 572 of the rinse solutionconduit attains the higher preset pressure at which pressure switch 583signals controller 164 to turn off rinse pump 150. When trigger 156 ofvacuum wand 104 is depressed, the pressure in branch 572 of the rinsesolution conduit near the nozzle 152 is relieved so that the rinsesolution stored under pressure in accumulator 584, flows out ofaccumulator 584 through rinse solution conduit 126 and eventually nozzle152. As rinse solution leaves accumulator, accumulator 584 contracts.When accumulator 584 contracts sufficiently so that the pressuremeasured by pressure switch 583 reaches the lower preset pressure (suchas 12 psi noted above), switch 583 signals controller 164 to activaterinse pump 150 to pump rinse solution into rinse solution conduit 126and accumulator 584. In this way the rinse solution provided at nozzle152 is not subject to surges of rinse solution that otherwise would becaused by operation of rinse pump 150. Accordingly, the combination ofpressure switch 583 and accumulator 584 forms part of a means forproviding rinse solution on-demand from the fluid stored under pressurewithin accumulator 584.

In an alternative embodiment of the automatic activation means for therinse pump shown in FIG. 40, upon sliding drawer 515 out of compartment111, a microswitch 109 activates and sends an alert signal to controller164 (FIG. 9) which is electrically connected to rinse pump 150 viacables 226. Microswitch 109 can be disposed either on drawer 515 orwithin compartment 111, as desired. Controller 164 is programmed so thatwhen controller 164 receives an alert signal from microswitch 109indicating that the operator has obtained access to vacuum wand 104,controller 164 sends an electrical control signal which activates rinsepump 150 to provide rinse solution to vacuum wand 104. Thereafter,manual activation of rinse trigger switch 156 releases a spray of rinsesolution 154 (FIG. 11) from spray nozzle 152.

As shown in FIG. 10 in a further alternative embodiment of the automaticactivation means for the rinse pump, access to storage compartment 111desirably can be provided via a top mounted door 115 that swings openfrom the top down. Upon opening door 115, a microswitch 109 activatesand sends an alert signal to a controller 164 which is electricallyconnected to rinse pump 150 via cables 226. Microswitch 109 can bedisposed either on door 115 or within compartment 111, as desired.Moreover, in another alternative embodiment of the rinse pump automaticactivation means, microswitch 109 can be disposed and configured so thatit activates pump 150 when suction line 106 is removed from between apair of guides 240 instead of when door 115 is opened.

During a cleansing operation, rinse solution at a low pressure isejected from the center portion of the spray nozzle 152 to assistwashing the filter sheet 580, 80 and/or the patient. The pressure ofthis rinse solution is not so great that it might damage any wounds onthe patient, bed sores on the patient, or peeling burns or other skin onthe patient. After the majority of rinse liquids and waste materialshave been vacuumed away through vacuum wand 104 at the conclusion ofeach waste-producing episode, the filter sheet desirably is toweled dry.

As embodied herein and shown schematically in FIGS. 1, 9, 15 and 16 forexample, the apparatus of the present invention desirably includes atleast one control panel 168. Desirably, as shown in FIG. 1 for example,control panel 168 is mounted to a foot-end guard rail 39. Moreover, aseparate and identical control panel 168 can be mounted to each of thefoot-end guard rails 39 of a bed so that the user can have access to acontrol panel from each side of the bed. As shown in FIG. 23A, eachcontrol panel 168 desirably is provided with a plurality of indicators,which desirably are in the form of short messages appearing in a LEDdisplay 128. Each control panel 168 desirably is provided in afluidproof configuration and is electrically connected to controller 164via a multi-conductor cable 272 (FIG. 9).

In still further accordance with the present invention, a means isprovided for heating the spray of liquid that is provided by thecleansing means. Desirably, a means is provided for controlling thetemperature of the liquid provided by the cleansing means. It also isdesirable to provide a means that safeguards against the cleansing meansproviding liquid that is too hot to be applied to the patient. Asembodied herein and shown schematically in FIG. 38 for example, theliquid heating means desirably includes a heat exchanger 542 disposed inthe path of one alternative route provided by a branch 543 of rinsesolution conduit 126. The heat exchanger branch 543 of the rinsesolution conduit is routed via a three-port, two-way liquid flowdiverter valve 508, which can be configured in one of two Ways under thecontrol of controller 164. The liquid heating means further desirablyincludes a heater control unit 544 that controls the provision ofelectricity to a heating element 545 disposed within heat exchanger 542and receives temperature information from within heat exchanger 542 viaa temperature sensor 546 that provides electrical signals to heatercontrol unit 544. Controller 164 is preprogrammed to monitor how heatercontrol unit 544 is operating the heating element 545 of heat exchanger542.

As embodied herein and shown in FIG. 38 for example, the means forcontrolling the temperature of the liquid provided to the cleansingmeans desirably includes a mixing valve, which is schematicallyrepresented by the dashed square box identified by the numeral 547.Mixing valve 547 has a first inlet connected to the heat exchangerbranch 543 of the rinse liquid conduit, which also has a direct branch548 that is routed directly from rinse solution container 142 via rinsepump 150. Mixing valve 547 also has a second inlet connected to thedirect branch 548 of the rinse liquid conduit. Direct branch 548 thusbypasses diverter valve 508 via a three-way conduit 549, which dividesthe rinse solution conduit 126 routed from rinse solution container 142via rinse pump 150 into heat exchanger branch 543 and direct supplybranch 548. Mixing valve 547 has a thermostat which is preset to controlthe relative proportion of heated and unheated rinse solution that ismixed in valve 547. As shown schematically in FIG. 38, mixing valve 547controls the flow from the direct supply branch 548, which carries theunheated rinse solution from rinse solution container 142, and the flowprovided via heat exchanger branch 543, which carries the heated rinsesolution from heat exchanger 542. Desirably, the rinse solution allowedto exit the outlet of mixing valve 547 has a temperature of 98° F. +or - 2° F. and can achieve this desired temperature of the mixed liquidwith liquid water entering valve 547 via direct supply branch 548 in therange of from 60° F. to 90° F. and liquid water entering valve 547 viaheat exchanger branch 543 in the range of from 105° F. to 150° F. Anexample of a suitable embodiment of mixing valve 547 is the THERMOTECHModel No. M/D-WWM098 thermostatically controlled water/water mixingvalve, which is available from Therm-Omega-Tech, Inc., of Oreland, Pa.

As embodied herein, the means that safeguards against the cleansingmeans providing liquid that is too hot to be applied to the patient,includes a temperature sensor 571 that is disposed in the branch 572 ofthe rinse liquid conduit exiting (and therefore downstream of) mixingvalve 547. Safeguard temperature sensor 571 provides temperatureinformation to controller 164. When the temperature provided tocontroller 164 by sensor 571 exceeds a preset value such as 105° F. forexample, controller 164 signals heater control unit 544 to deactivateheater element 545 and controller deactivates rinse pump 150. In thisway, controller 164 deactivates the rinse liquid system and preventsapplication of hot rinse liquid to the patient. Controller 164 alsoactivates a CALL FOR SERVICE message on the display 128 (FIG. 23A) ofside rail control panel 168 and prevents operation of the rinse systemagain until the system has been reset.

In yet further accordance with the present invention, a means isprovided for reducing the power demand requirements of providingon-demand heated liquid for the cleansing means. As embodied herein andshown in FIG. 38, the power management means of the present inventiondesirably uses excess power available during normal operation of thewaste managing means to generate thermal energy that is stored in a heatexchanger 542 and draws on this stored thermal energy during times ofpeak power demand to provide heat for maintaining the temperature of therinse liquid supplied to the cleansing means. The power management meansincludes controller 164, which is preprogrammed as follows. When heater545 is drawing power and vacuum blower 102 is running on low speedduring normal operation of the waste managing means and the patientsupport system, about 10 to 10.5 amps of current are being drawn fromthe wall receptacle. When suction is supplied to vacuum wand 104, vacuumblower 102 is switched to high speed and then draws an additional 5amps. To keep from drawing over the allowable current limit of 12.5 ampswhen the vacuum blower is on high speed, controller 164 deactivatesheater 545, which saves about 5 amps. When heater 545 is deactivated,the heating of the rinse solution depends on the heat storage mass ofheat exchanger 542. When vacuum blower 102 is switched back to lowspeed, controller 164 reactivates heater 545. Also when controller 164determines that any of the motors that control the articulation of thepatient support surface of the bed are operating, controller 164deactivates vacuum blower 102 to keep the bed from drawing too muchcurrent from the wall receptacle. Controller 164 resupplies power tovacuum blower 102 when the motors are disengaged.

In still further accordance with the present invention, a means can beprovided for receiving the rinse solution container. As embodied hereinand schematically shown in FIGS. 26 and 28 for example, the rinsecontainer receiving means desirably includes a first housing 172configured for receiving rinse solution container 142. Depending uponthe particular embodiment of the present invention, first housing 172can be provided as part of a bed, or as part of a service cart 256, oras part of an emergency treatment table, or the like. For example, firsthousing 172 can be carried by the bed frame beneath the footboard andfixed to upper frame 36 as shown generally in FIG. 28 for example. Asschematically shown in FIG. 28 for example, first housing 172 desirablyincludes a slide receptacle 173 which slidably and nonrotatably receivesa mating groove member 174 (FIGS. 6, 28 and 29B) defined by a pair ofopposed overhanging flanges 181 which are formed as part of or connectedto the upper portion of the exterior side walls of rinse jug 142. Asshown in FIG. 28 for example, insertion of opposed inward-facingelongated cam members of receptacle 173 into groove member 174 of rinsejug 142 ensures proper alignment of rinse jug 142 with respect to firsthousing 172 whenever the rinse jug is secured by first housing 172.

As shown schematically in FIGS. 12 and 12A or 15 and 16 for example, thefirst housing can be formed as part of the upright frame 258 (FIGS. 15and 16) or low profile portion 264 of a mobile service cart 256. In somesuch embodiments, the rinse solution container 142 can be provided as apermanent part of the service cart. As shown schematically in FIG. 16for example, a fill hose 143 is provided for introducing additionalrinse solution into rinse jug 142 and is desirably held within theservice cart by a bracket 141.

In still further accordance with the present invention, the firsthousing includes means for automatically connecting the rinse solutioncontainer in communication with the rinse spray nozzle of the vacuumwand when the first housing receives the rinse solution container. Whenthe first housing receives the rinse solution container, the rinsecontainer connecting means becomes engaged, and the rinse solution jugthereby automatically becomes engaged in communication with the rinsespray nozzle of the vacuum wand. Moreover, the rinse containerconnecting means is configured to prevent any of the rinse solution fromdraining out of the rinse liquid supply conduits and escaping from theconnecting means when the connecting means is disengaged and the firsthousing disengages from the rinse solution container. By preventingliquid from draining out or rinse liquid supply conduits 126, the rinsecontainer connecting means keeps rinse liquid supply conduits 126 fulland thus provides means for on-demand supply of rinse liquid to nozzle152 of vacuum wand 104.

As embodied herein and shown schematically in FIGS. 14 and 26 forexample, the rinse container connecting means desirably includes adripless connector, which is generally designated by the numeral 180 inFIG. 14 and forms inlet/outlet valve 148 shown in FIG. 26. A suitableembodiment for dripless, quick-disconnect type connector 180 is aconnector that is available from Colder Products Company as modelPLCD-160-06 for the female member 184 and PLCD-420-06 for the malemember 182. Desirably, dripless, quick-disconnect connector 180 islocated in the upper portion of the back endwall 147 of rinse solutionjug 142. Accordingly, rinse jug 142 can be removably securable to apatient support apparatus or to a service cart 256 via the firsthousing, the connecting means, and the coupling means.

As schematically shown in FIG. 14, dripless connector 180 includes botha male member 182 and a female member 184, either one of which beingprovided as inlet/outlet valve 148 (FIG. 9) attached to the exterior ofrinse jug 142. The other of the male and female members of driplessconnector 180 is formed as part of or attached to the portion of theexterior of first housing 172 that is connected in communication withrinse solution conduit 126. Each of male member 182 and female member184 includes a hose fitting 183 which can be connected to the end of ahose such as rinse solution conduit 126 or siphon tube 146, dependingupon whether the member 182 or 184 is attached to first housing 172 orrinse jug 142. Moreover, each of male member 182 and female member 184includes a spring 186 disposed and configured to bias a poppet typeclosure 187 to seal the respective opening 188 to its respectivepassageway 189 immediately upon being disengaged from one another, thusrendering connector 180 dripless.

The receiving means for the rinse solution container also desirablyincludes means for positively locking the rinse solution container intothe receiving means. In a presently preferred embodiment of thepositively locking means, and as shown schematically in FIG. 26B forexample, a positive locking mechanism is provided in the form of a flatspring 711 disposed above the slide receptacle (not shown) in the narrowchannel 225 between first housing 172 and the slide receptacle. Flatspring 711 has one end attached to first housing 172 and defines alatching member 712 near the free end thereof. Latching member 712defines a ridge 713 that is biased by spring 711 into a position thatsecures jug 142 into first housing 172 and male member 182 into femalemember 184 of connector 180. Latching member 713 defined at the free endof spring 701 can be lifted by the operator from the position shown indashed lines in FIG. 26B to permit withdrawal of jug 142. In thispresently preferred embodiment, connector 180 shown in FIGS. 14, 14A and14B would be modified to eliminate the positive locking mechanism thatincludes locking spring 199 and locking member 200 configured with ringportion 208 and release flange 203.

In a first alternative embodiment of the positively locking means shownschematically in FIG. 26A for example, a flat spring 701 disposed aboveslide receptacle 173 in narrow channel 225 between first housing 172 andthe slide receptacle (not shown). Flat spring 701 has one end attachedto first housing 172 and defines a detent 702 near the free end thereof.Detent 702 is biased into a position that secures jug 142 into firsthousing 172 and male member 182 into female member 184 of connector 180.A release flange 703 defined at the free end of spring 701 can be liftedby the operator to the position shown in dashed lines in FIG. 26A topermit withdrawal of jug 142. In this first alternative embodiment,connector 180 shown in FIGS. 14, 14A and 14B would be modified toeliminate the positive locking mechanism that includes locking spring199 and locking member 200 configured with ring portion 208 and releaseflange 203.

In a second alternative embodiment of the positively locking means shownschematically in FIGS. 14, 14A, 14B, and 26 for example, a positivelocking mechanism is provided as part of dripless, quick-disconnect typeconnector 180, which automatically snaps together or separates by theapplication of moderate manual force to a mechanical locking means. Asshown in FIG. 14 for example, connector 180 is provided with aquick-disconnect mechanism that includes a locking spring 199 configuredand disposed to bias a locking member 200 which is configured with aring portion 208 (FIG. 14B) that is slidably received in a locking slot201 formed to extend circumferentially in a transverse direction withinfemale member 184. When male member 182 is inserted into female member184, the inner edge 205 of ring portion 208 of locking member 200 isengaged by a circumferential groove 202 formed in the exterior of malemember 182. Such engagement provides a positive locking force whichprevents unwanted movement of rinse jug 142 from first housing 172.Disengagement of locking mechanism involves pressing a release flange203 formed as part of locking member 200. When the release flange 203 ispressed, locking member 200 moves against its biasing spring 199 and outof the circumferential groove 202 of male member 182. At the same time,the springs 186 which bias the poppet closures 187 in the male andfemale members 182, 184 provide forces in a direction that separatesmale member 182 from female member 184, thus providing aquick-disconnect force. In addition, as shown in FIGS. 14A and 14B, whenring portion 208 moves to compress locking spring 199, a pin biasingspring 207 moves a tapered bottle nose pin 209 out of a slot 211 definedin ring portion 208 and provides a force which acts in a direction thatseparates male member 182 from female member 184, thus providing aquick-disconnect force.

As shown in FIGS. 26 and 28 for example, release flange 203 is pressedwhen the operator pushes a release button 215 disposed near and abovethe entrance to slide receptacle 173. Release button 215 is connected toone end of an elongated push rod 217 which is confined within a narrowchannel 225 disposed above and extending along the length of slidereceptacle 173. The opposite end of push rod 217 is pivotally connectedto one end of an arm 227. The opposite end of arm 227 is pivotallyconnected to one end of a plunger 229 which is slidably mounted to movein the vertical direction in a mounting block 231 attached to the backwall 233 of first housing 172. The opposite end of plunger 229 isconfigured and disposed to press against release flange 203 when theoperator pushes release button 215 toward back wall 233 of first housing172.

In accordance with the present invention, a means can be provided fordetecting when the rinse solution container is securably received by thefirst housing and providing a signal upon detecting such securablereceipt or the absence of same. Desirably, the securably receiveddetecting means is connected to provide its signal to the controller,which can indicate receipt of such signal by actuating an indicatormeans of a control panel. As embodied herein and shown schematically inFIG. 43 for example, the securably received detecting means for therinse jug preferably can include a micro-switch 708 which is activatedby a spring-biased plunger 710 installed in first housing 172.Micro-switch 708 is electrically connected to a gate circuit element 47,which is electrically connected to controller 164. When rinse jug 142 isproperly installed in first housing 172, plunger 710 is depressedsufficiently against the biasing spring to open the contacts of switch708. When switch 708 is opened, gate 47 sends to controller 164 arelatively high voltage signal from the reference voltage indicatedschematically in FIG. 43 as positive 5 volts. Plunger 710 andmicro-switch 708 are disposed and configured so that the contacts ofswitch 708 do not open unless male member 182 of connector 180 is lockedinto female member 184. When the rinse jug 142 is removed from firsthousing 172, the plunger 710 is released and causes switch 708 to close,Which sends a relatively low voltage signal to controller 164 as thepositive reference voltage is drained to ground. When controller 164receives the signal from micro-switch 708 indicating that rinse jug 142is not making proper connection in first housing 172, controller 164turns off rinse pump 150 and activates display of a message on thesiderail control panel 168 and sounds an audible alarm to inform theoperator that the rinse jug 142 has been removed or is not properlyinstalled in first housing 172. When the rinse jug 142 is reinstalledproperly, controller 164 receives the appropriate signal frommicro-switch 708, and the message and alarm are cleared.

An alternative embodiment of the securably received detecting means isshown schematically in FIGS. 9, 27 and 29B for example and can include afirst contact plate 190 that is electrically conducting and disposed onthe exterior of the back endwall 147 of rinse jug 142 at a level nearthe bottom of jug 142. Plate 190 is mounted to the jug's back endwall147 by at least one electrically conducting attachment screw 41, whichextends into the interior of rinse jug 142 and contacts the rinsesolution contained therein. As shown schematically in FIG. 26 forexample, a pair (only one is visible in the FIG. 26 view) of electricalcontact probes 43, 45 is disposed to extend from the back wall 233 offirst housing 172, which back wall 233 faces opposite the back endwall147 of jug 142 when rinse solution jug 142 is securely received by firsthousing 172. Each electrical contact probe is desirably a spring loadedprobe with a waffle tip configuration such as is available fromInterconnect Devices, Inc. of Kansas City, Kans. The waffle tipconfiguration (not shown) provides multiple point electrical contact. Asschematically shown in FIG. 27 for example, one probe 43 is connected toground, and the other probe 45 is connected to a gate circuit element 47with a positive reference voltage connected between gate 47 and gateprobe 45. These probes 43, 45 are disposed and configured so that theydo not make contact with first contact plate 190 unless male member 182of connector 180 is locked into female member 184. When both groundprobe 43 and gate probe 45 touch first contact plate 190, they completean electrical circuit that shorts the reference voltage to groundthrough first plate 190 and ground probe 43, and gate 47 sends a firstsignal to controller 164 via cable 123 indicating that both probes aretouching plate 190.

Upon receipt of this first signal, controller 164 can be programmed toactivate an indicator or not, depending on how the indicator scheme isdesigned to alert the operator for the secured presence of rinse jug142. For example, when both probes fail to touch first contact plate190, gate 47 continues to receive the reference voltage and sends asecond signal to controller 164 indicating that contact plate 190 is nottouching both probes 43 and 45. When controller 164 receives this secondsignal, controller 164 activates an indicator means that informs theoperator that rinse jug 142 is not operatively connected to rinsesolution conduit 126. As embodied herein and schematically shown in FIG.23A for example, the indicator means can include an indicator in theform of a light or "ATTACH RINSE JUG" message in a LED display 128and/or buzzer mounted on control panel 168. An alternative embodiment ofthe indicator means can include an indicator 280 in the form of a lightor LED "JUG REMOVED" message (FIG. 23) and/or buzzer mounted on controlpanel 168. Thus, the indicator enables the operator to determine whenrinse jug 142 has been removed from first housing 172, as when jug 142is being refilled with rinse solution. Moreover, if rinse jug 142 isremoved, controller 164 desirably is programmed so that it does notpermit activation of rinse pump 150.

In accordance with the present invention, a means is provided fordetecting a predetermined level of liquid in the rinse solutioncontainer and providing a signal upon detecting same. Desirably, therinse solution level detecting means is configured to detect when thelevel of rinse solution has become so low as to require filling therinse solution container with additional rinse solution. As embodiedherein, the rinse solution level detecting means can include a liquidsensor element that is configured, mounted and disposed for detecting apredetermined level of rinse liquid inside rinse jug 142. The liquidsensor element for the rinse jug level sensor preferably is a capacitiveproximity level sensor 740 configured as schematically shown in FIGS. 42and 42A for example. As schematically shown in FIG. 42, the capacitiveproximity level sensor 740 does not come in contact with the rinseliquid 741 inside the container (such as rinse jug 142), but detects thepresence of liquid by emitting an electronic or electrical signal whenthe liquid comes into close proximity of the sensor. Suitable capacitiveproximity liquid level sensors are available from Electromatic ControlsCorporation of Hoffman Estates, Illinois. The sensor 740 desirably isheld in a mounting 50 which will dispose the sensor near the desiredlevel of the container 752 carrying the liquid of interest. In thepresent instance, mounting 750 is conveniently provided by the firsthousing 172, and container 752 is conveniently provided by rinse jug142. Sensor 740 is disposed in first housing 172 at a level which willbe disposed near the bottom of rinse jug 142 when the rinse jug isproperly installed into first housing 172. The sensor 740 desirably isdisposed to be in contact with the outside surface of rinse jug 142 whenthe jug is secured in first housing 172. When the rinse solution hasbeen depleted to a level that is below the sensor, the sensor sends asignal via a cable 742 to interface circuit 743, which sends a signal tothe CPU of controller 164. When controller 164 receives this low liquidlevel proximity signal from the rinse jug liquid level sensor 740,controller 164 turns off the rinse pump 150, sends an instructivemessage, such as "FILL RINSE JUG", to the LED display 128 (FIG. 23A) ofsiderail control panel 168, and can sound an audible alarm to inform theoperator that more solution needs to be added to the rinse jug 142. Whenthe rinse jug 142 is removed, refilled, and properly reinstalled intofirst housing 172, the controller 164 clears the message and any alarm.

A capacitive level sensor 740 such as employed in the present inventionis a device that operates according to principles that govern thebehavior of a damped RC oscillator. As schematically shown in FIGS. 42and 42A, the sensor 740 projects an electrostatic field 744 into thespace adjacent the sensor. When an object enters the field 744, thedielectric characteristics of the space occupied by the field, changeand produce oscillations in the field. If the object containsungrounded, conductive material, the object also causes interference inthe electrostatic field. When the object intrudes sufficiently into thefield to enter the so-called active zone of the sensor, the sensor'scircuitry detects the oscillation and generates an electrical signal inthe form of a trigger pulse that is used to change the state of theoutput driver, which is formed as a transistor switch 745. The outputdriver of the sensor is electrically connected to controller 164 via aninterface circuit 743. The sensor includes a potentiometer 746 that canbe adjusted to set the sensor's sensitivity to proximate objects.

By placing the liquid level sensor 740 on the outside of a plasticcontainer such as rinse jug 142 or waste jug 192 or reservoir 100 andadjusting the sensitivity, the sensor can detect the presence of liquidwhen the liquid moves to a level that enters the active zone of theelectrostatic field. As schematically shown in FIG. 42, when the liquidlevel is in the active zone, the output driver 745 of the sensor isturned ON and drains to ground the current through the interface pull-upresistor 747 of the interface circuit of controller 164. The comparator748 of the interface circuit detects this signal as a low state andsends this condition to controller 164, which then performs an actiondetermined by the programming. When the liquid is removed from theactive zone of the sensor, the sensor's output transistor 745 is turnedoff so that the path for current drain from the interface pull-upresistor 747 is broken. The interface input comparator 748 detects thissignal as a high state and sends this condition to controller 164.

A first alternative embodiment of a means for detecting a predeterminedlevel of liquid in the rinse solution container is shown schematicallyin FIGS. 26, 27 and 29B. In this first alternative embodiment, theliquid sensor element includes at least two threaded metallic screws 41,though more than two can be provided. At least one screw 41 secures anelectrically conducting second contact plate 160 to the exterior of jug142 and extends through the back endwall of jug 142 and inside jug 142.Each screw 41 in second contact plate 160 desirably is disposed at thesame low level near the bottom of rinse jug 142 and above the openentrance end of siphon tube 146. As shown schematically in FIG. 27 forexample, each liquid sensor screw 41 attached to second plate 160 formspart of an electrical detection circuit that includes the second contactplate 160 and a third probe 170 and produces an electrical response whenthe level of liquid within rinse jug 142 uncovers all of the rinseliquid sensor screws 41 attached to plate 160 and extending inside jug142.

As schematically shown in FIG. 9 for example, the detection circuit forthe level of liquid inside rinse jug is electrically connected tocontroller 164 via electrical cables 166. As schematically shown in FIG.27 for example, the voltage at a comparator circuit element 171 isconnected to a positive reference voltage, a capacitor 175, and thirdprobe 170. Capacitor 175 is connected to ground. The voltage at thecomparator 171 stays below the positive reference voltage, typically alow voltage of positive 5 volts for example, so long as the level ofrinse solution inside rinse jug 142 stays above at least one of theliquid sensor screws 41 attaching second contact plate 160 to jug 142and extending inside jug 142. This is because the capacitor shorts toground through third probe 170, the electrically conducting rinsesolution inside rinse jug 142, and ground probe 43. When the voltage atcomparator 171 falls below the reference voltage, comparator 171 sends afirst signal to controller 164. When the liquid inside jug 142 fallsbelow the level of the liquid sensor screws 41 attaching second contactplate 160 to jug 142 and extending inside jug 142, the voltage atcomparator 171 is the reference voltage, and comparator 171 sends asecond signal to controller 164. This, is because the electrical path toground through ground probe 43, the electrically conducting rinsesolution inside jug 142, and third probe 170, is broken.

In yet further accordance with the present invention, a means can beprovided for automatically coupling the rinse level detecting means tothe controller when the rinse jug is received by the first housing. Asembodied herein and schematically shown in FIG. 27 for example, theautomatic coupling means desirably includes a pair of electricallyconducting probes 43, 170. As shown schematically in FIG. 26 forexample, probes 43, 170 are attached to the back endwall 233 of firsthousing 172. Moreover, when rinse jug 142 is received in first housing172 and connector 180 is engaged, ground probe 43 is configured anddisposed to make contact with first contact plate 190 while comparatorprobe 170 is configured and disposed to make contact with second contactplate 160 as well as being connected to controller 164 via cables 166.Probes 43, 170 thus cooperate with the slide receptacle 173 and driplessconnector 180 to provide a means for coupling the rinse liquid levelsensor in communication with a signal emitting means wherein thecoupling means is automatically engageable when first housing 172securely receives rinse solution container 142.

A second alternative embodiment of the rinse solution level detectingmeans can be provided in a form which includes a float switch, which canbe disposed with respect to rinse jug 142 so as to detect when jug 142is almost empty. The float switch can be a magnetic reed switch (notshown) which is configured and disposed so that when it reaches apredetermined low level inside jug 142, it sends a low level signal tocontroller 164.

An alternative embodiment of a means for emitting a signal when therinse liquid level sensor detects a predetermined level of fluid in therinse solution container, is shown schematically in FIG. 9 for example.In the alternative embodiment, the signal emitting means can include anindicator 278 such as a buzzer or LED "RINSE JUG EMPTY" message (FIG.23) which is mounted on control panel 168 and activated by controller164 when controller 164 receives the second signal from comparatorcircuit element 171 indicative of a low supply of rinse solution insiderinse jug 142. Thus, indicator 278 alerts the operator when the amountof rinse fluid in the rinse solution jug 142 is almost completelydepleted, and therefore additional rinse solution should be added tofill rinse jug 142.

In still further accordance with the present invention, the removingmeans desirably includes a means for detecting and signaling whenliquids, such as from a patient incontinence event for example, need tobe removed from the patient environment, collected and contained fordisposal. The liquid detecting and signaling means desirablycommunicates with at least one of the catching means and the removingmeans. As embodied herein and shown in FIG. 9 for example, the liquiddetecting and signaling means can include a moisture sensor, which isindicated generally by the designating numeral 216. Desirably, moisturesensor 216 is disposed so that it can detect moisture in at least one ofthe catching means and the removing means and be able to emit a signalin response to detecting such moisture. As shown in FIGS. 9, 18 and 18Afor example, moisture sensor 216 desirably is disposed for detectingmoisture in cylindrical portion 63 of drain fitting 67 near the entranceto waste removal conduit 98 and accordingly can detect moisture beforethat moisture passes through waste removal conduit 98. Moisture sensor216 is desirably disposed to detect moisture before that moisturereaches the collecting means-(described below). As shown schematicallyin FIGS. 9, 18 and 18A for example, moisture sensor 216 can include apair of electrically conducting elements 218, 220. Each electricallyconducting element 218, 220 can be formed of a one half inch widestainless steel strip having both ends connected to one another to forma ring. Each ring 218, 220 has an internal diameter of about one-halfinch.

As embodied herein and schematically shown in FIGS. 18 and 18A forexample, each ring 218, 220 is press-fitted into a groove defined in theinside surface of a portion of drain fitting 67 disposed near the freeend 81 (not shown in FIG. 18A) of the cylindrical portion 63 of drainfitting 67. A one quarter inch width spacer ring 219 is formed ofinsulating material with the same radius and thickness as each ring 218,220 and is press-fitted into the same groove between ring 218 and ring220. As indicated schematically in FIGS. 9, 18 and 18A, rings 218, 220are electrically connected in an electrical circuit including lead wires222 and controller 164. As schematically shown in FIGS. 18 and 18A forexample, the moisture detection mechanism formed by rings 218, 220 isvery sensitive to moisture such that when moisture flows between the tworings 218, 220, current flows through lead wires 222 to an electricalcircuit 221 which sends an electrical signal via a cable 223 tocontroller 164.

The liquid detecting and signaling means further includes an electricalsignaling mechanism that emits a signal perceivable by the patient orattending personnel when moisture flowing within drain fitting 67 formsan electrical connection between rings 218, 220 and sends an electricalsignal to controller 164. A suitable signaling mechanism can produce anaudible and/or visible signal. As schematically illustrated in FIGS. 9,23 and 23A for example, a suitable signaling mechanism can include anelectrical buzzer 281 and/or an "EVENT" light emitting diode (LED) 282which can be mounted on a control panel 168 of a patient supportapparatus (FIG. 12A) or service cart 256 (FIGS. 15, 16), if desired.Desirably, the indicator mechanism is activated by controller 164 whencontroller 164 receives a moisture detection signal from rings 218, 220or any other embodiment of the moisture detection mechanism.

As shown in FIGS. 9, 23 and 23A for example, a reset button 284 also canbe provided as part of control panel 168 to enable the user to reset themoisture detection indicator mechanism. When reset button 284 isactivated, controller 164 turns off the audible alarm and stops theflashing of the event alert LED 282 mounted on siderail control panel168. In addition, controller 164 begins an 8 minute timed suppression ofany more episode alerts. If the rinse pump is turned on during this 8minute timed suppression, controller 164 restarts the 8 minutesuppression. This eliminates false detection of moisture in the basinduring a clean-up operation. At the expiration of the 8 minute timedsuppression, controller 164 terminates the suppression of the episodealert circuits.

In an alternative embodiment of the present invention, a means can beprovided for controlling operation of the vacuum blower in response tomoisture detection by the liquid detecting and signaling means. Such avacuum blower control means desirably can be connected to the vacuumblower and to the liquid detecting and signaling means. As schematicallyshown in FIG. 9 for example, such a vacuum blower control meansdesirably can include controller 164 electrically connected to thecircuit including rings 218, 220 via cable 222 and electricallyconnected to vacuum blower 102 via a cable 224. Controller 164 can beprogrammed so upon receipt of a signal from the moisture detectionmechanism indicating that moisture has entered the cylindrical portion63 of drain fitting 67, controller 164 can activate blower 102 toinitiate and/or increase suction that pulls the moisture out of basin62, fitting 67, and conduit 98 and into holding reservoir 100.Controller 164 can be programmed to continue to operate vacuum blower102 in this manner, until moisture sensor 216 no longer detects anyliquid. After a short time interval from the time when moisture sensor216 fails to detect any liquid, controller 164 can be programmed to senda signal to discontinue operation of vacuum blower 102. In addition,controller 164 can be programmed to delay the deactivation of blower 102for about 10 or 20 seconds so that waste can continue to be vacuumedfrom waste removal conduit 98, basin 62 and drain fitting 67. The shortdelay time enables basin 62, drain fitting 67, and conduit 98 to becleared of all liquid before the blower deactivates.

In yet further accordance with the present invention, a means isprovided for collecting the waste removed from the waste catching meansby the waste removing means. The waste collecting means desirably isdisposed so as to be in communication with the waste removing means andfacilitates containment of the waste materials at a location that isisolated from the patient and from persons attending the patient.Moreover, the waste collecting means desirably facilitates permanentdisposal of the waste materials. As embodied herein and schematicallyshown in FIGS. 6, 9 and 28 for example, the collecting means desirablyincludes a waste collection container 192 in the form of a waste jug192. A handle 144 is defined in a front endwall 145 of jug 192, whichdesirably is formed of liquid impermeable material such as high densitypolyethylene (HDPE), or polypropylene, or polycarbonate, or any similarrigid plastic material. Depending on the embodiment, the wastecollection container can be configured to be removably securable to thepatient support apparatus (FIG. 1) or to a transportable service cart256 (FIGS. 12, 12A, 15 and 16 for examples) or can be formed as apermanent tank of the service cart. As shown in FIG. 29A for example,waste jug 192 desirably has a capacity of 4 liters and can be emptied ofwaste via a pour opening 149 (shown in dashed line in phantom) which isdefined at the free end of a circularly cylindrical annular member 151(shown in phantom). The annular member desirably can be provided with anexterior surface having screw threads so that pour opening 149 isremovably sealable by means of a screw-on threaded cap.

As embodied herein and shown schematically in FIG. 9 for example, thecollecting means can further include a waste transfer pump 194 and wastetransfer conduits 196. Waste transfer conduits 196 connect an outletopening 198 defined in the bottom of holding reservoir 100 to waste jug192 via waste transfer pump 194. Thus, waste collection jug 192 isdisposed so as to be in communication with holding reservoir 100 viawaste transfer conduits 196 and waste transfer pump 194. Waste transferconduits 196 desirably can be formed of polyvinyl chloride (PVC)flexible tubing having a three-eighths inch interior diameter and acircular transverse cross-section. A suitable waste transfer pump isprovided by a 2 inch bellows pump with a rated flow rate of 0.3 gallonsper minute at 20 psi through three-eighths inch internal diameter tubingwhen powered by a 120 volt 60 cycle AC single phase electric motor.

In still further accordance with the present invention, a means can beprovided for automatically controlling operation of the waste transferpump so as to transfer waste from the removing means to the wastecollection container whenever a predetermined minimum level of waste hasaccumulated within the holding reservoir. As embodied herein, the meansfor automatically controlling operation of the waste collection means soas to transfer waste from the removing means to the collection means,desirably includes a means for detecting when the removing means becomesfilled to a predetermined proportion of its capacity.

As embodied herein and schematically shown in FIG. 49A for example, ameans for detecting when the removing means becomes filled to apredetermined proportion of its capacity, preferably includes a lowlevel liquid sensor which preferably can be provided in the form of acapacitive proximity level sensor 500 which is disposed near the bottomof holding reservoir 100. Capacitive proximity level sensor 500desirably is disposed against the outside surface of reservoir 100 sothat sensor 500 does not come into contact with the waste liquid insidereservoir 100. Low level reservoir sensor 500 for holding reservoir 100desirably is part of an electronic arrangement similar to the means fordetecting the level of rinse liquid inside rinse jug 142, describedabove and illustrated schematically in FIGS. 42 and 42A, and isconnected electrically and/or electronically to controller 164. In thepresent case, mounting 750 (shown in FIG. 42) disposes sensor 500against the outside of reservoir 100, which corresponds to container 752shown in FIG. 42. Low level sensor 500 sends a signal to controller 164when liquid is detected near sensor 500. This detection of the proximityof liquid to sensor 500 indicates that enough liquid exists in reservoir100 to begin a transfer operation. When controller 164 receives a liquidproximity signal from this low level sensor 500, controller 164 turns onliquid waste transfer pump 194 to move the waste liquid from reservoir100 into the waste holding jug 192. Controller 164 continues operatingwaste transfer pump 194 until the liquid level in reservoir 100 has beendecreased to a level that is sufficiently below the low level sensor 500so that low level sensor 500 ceases to send a liquid proximity signal tocontroller 164. Low level sensor 500 then signals to controller 164 thatthis condition of insufficient liquid inside reservoir 100 has occurred,and controller 164 then turns off waste transfer pump 194.

As schematically shown in FIG. 9, an alternative embodiment of a meansfor detecting when the removing means becomes filled to a predeterminedproportion of its capacity, includes a low level-liquid sensor in theform of a low reservoir probe 131 such as a stainless steel screw of thetype that can be used for the rinse solution level detecting meansembodiment shown in FIGS. 96 and 27 for example. Thus, a secondstainless screw (not shown in FIG. 9) would be provided at the sameheight as screw 131 near the bottom of holding reservoir 100 andextending into the interior of reservoir 100 from a wall-thereof. Thissecond screw would be connected electrically to ground, and screw 131would be connected to the same electronic configuration as probe 170shown in FIG. 27. When probe 131 and the second screw are covered byliquid, an electrical signal is transmitted to controller 164 andindicates that a minimum level of liquid is contained in holdingreservoir 100.

As embodied herein, the means for detecting when the removing meansbecomes filled to a predetermined proportion of its capacity, preferablyincludes a high level liquid sensor which is connected electrically orelectronically to controller 164. As schematically shown in FIG. 49A forexample, the high level liquid sensor preferably is provided in the formof a capacitive proximity level sensor 507 that is disposed against theoutside of reservoir 100 so that sensor 507 does not come into contactwith the waste liquid inside reservoir 100. The high level sensor 507performs in the same manner as the capacitive liquid level proximitysensor for the rinse jug 142 illustrated schematically in FIGS. 42 and42A. The high level sensor 507 is located at a predetermined level abovethe bottom of reservoir 100 to detect when and if the liquid level hasincreased to a point where the liquid could be sucked into the inlet ofvacuum blower 102. Typically this condition should never occur. If thiscondition should occur, the high level sensor 507 sends a liquidproximity signal to controller 164 when the waste liquid insidereservoir 100 reaches a level sufficiently close to high level sensor507. When controller 164 receives the liquid proximity signal from highreservoir sensor 507, controller 164 desirably performs severalpreprogrammed functions. For example, upon receipt of the high levelliquid proximity signal from the high level liquid sensor, controller164 disables operation of vacuum blower 102 and rinse pump 150. Whencontroller 164 disables vacuum blower 102, no suction from waste removalconduit 98 and/or a vacuum wand 104 can introduce additional wastes intothe holding-reservoir 100 which is nearing its capacity. Moreover, whilecontroller 164 is preventing operation of vacuum-blower 102 and rinsepump 150, no more liquid will be added to reservoir 100 until wastetransfer pump 194 has been able to decrease the liquid level to a safelevel. When enough liquid has been transferred from reservoir 100 to thewaste holding jug 192 to drop the level of liquid inside reservoir 100below the level at which the high level sensor issues a liquid proximitysignal to controller 164, then controller 164 reactivates vacuum blower102 and ceases disabling rinse pump 150. In addition, controller 164 canactivate a warning indicator 128 on control panel 168 (FIG. 23A) toalert the operator that the liquid inside holding reservoir 100 is atthe predetermined level which indicates that the holding reservoir isnearing its full capacity. Detection of liquid at such a high levelinside holding reservoir 100 could indicate the occurrence of a systemmalfunction that should be investigated by service personnel. Thus, thewarning indicator preferably is provided in the form of an instructivemessage such as "CALL FOR SERVICE" on an LED display 128 (FIG. 23A) ofcontrol panel 168. However, in an alternative embodiment of panel 168shown in FIG. 23, a message which is merely informative such as "SERVICEREQUIRED" can be provided

As schematically shown in FIG. 9, an alternative embodiment of a meansfor detecting when the removing means becomes filled to a predeterminedproportion of its capacity, includes a high level liquid sensor that isprovided in the form of a stainless steel screw 107 disposed near thetop of holding reservoir 100 and extending into the interior ofreservoir 100 from a wall thereof. The alternative embodiment of thehigh level liquid sensor for holding reservoir 100 desirably includes anelectronic arrangement similar to the means for detecting the level ofrinse liquid inside rinse Jug 142, described above, and is electricallyconnected to controller 164. Thus, a second stainless screw (not shownin FIG. 9) would be provided at the same height as screw 131 near thebottom of holding reservoir 100 and extending into the interior ofreservoir 100 from a wall thereof. This second screw would be connectedelectrically to ground, and high level screw 107 would be connected tothe same electronic configuration as probe 170 shown in FIG. 27. Whenscrew 107 and the second screw are covered by liquid, an electricalsignal is transmitted to controller 164 and indicates that a high levelof liquid is contained in holding reservoir 100.

In accordance with the present invention, a means can be provided forreceiving the waste collection container. As embodied herein and shownschematically in FIG. 28 for example, the waste collection containerreceiving means includes a second housing 206, which desirably isconfigured almost identically as first housing 172. Accordingly, thedescription of second housing 206 will concentrate on the differenceswhich exist between second housing 206 and first housing 172. Dependingupon the particular embodiment of the present invention, second housing206 can be provided as part of a bed 30, or as part of a service cart256, or as part of an emergency treatment table, or the like. Asschematically shown in FIG. 28 for example, second housing 206 can becarried by the bed frame beneath the footboard and fixed to the upperframe 36. As shown in FIG. 28 for example, second housing 206 includesat least one slide receptacle 173 which slidably and nonrotatablyreceives a mating groove member 174 (FIG. 6) defined as part of theexterior of waste jug 192 to ensure proper alignment of waste jug 192with respect to second housing 206.

As shown schematically in FIGS. 12 and 12A or 15 and 16 for example, thesecond housing can be formed as part of the upright frame 258 (FIGS. 15and 16) or low profile portion 264 of a mobile service cart 256. In somecart embodiments, the waste collection container 192 is provided as apermanent part of the service cart. As shown schematically in FIG. 16for example, a drain hose 193 is provided for emptying waste materialthat has accumulated in waste collection container 192. Drain hose 193is held by a bracket 191 and is connected to waste collection container192 via a quarter turn valve 197, which governs fluid transfer fromcontainer 192 into hose 193.

In further accordance with the present invention, a means can beprovided for connecting the waste collection container in communicationwith the holding reservoir. Desirably, the connecting meansautomatically engages the collection container into communication withthe holding reservoir when the second housing receives the wastecollection container. Moreover, the connecting means is configured toprevent waste from escaping when the collection container is disengagedfrom the second housing. As embodied herein and shown in FIG. 14 forexample, the waste jug connecting means desirably includes the same typeof dripless connector 180 which forms the rinse jug connecting means andis connected and disposed in waste jug 192 in a similar fashion asconnector 180 is connected and disposed in rinse jug 142 shown in FIG.26 for example. Thus, the waste jug connecting means desirably includesa dripless connector 180, which forms the inlet/outlet valve 148 andincludes both a male member 182 and a female member 184. In addition,the receiving means (second housing 206) for the waste collectioncontainer 192 also includes substantially the same type of means forpositively locking the waste jug into second housing 206 as the positivelocking means (both embodiments) for locking the rinse jug into firsthousing 172 and described above.

In further accordance with the present invention, a means can beprovided for detecting when the waste collection container is securablyreceived by the second housing and providing a signal upon detectingsuch securable receipt. Desirably, the waste jug securably receiveddetecting means is connected to provide its signal to the controller,which can indicate receipt of such signal by actuating an indicatormeans of a control panel. As embodied herein and shown schematically inFIGS. 9 and 44 for example, the securably received detecting means forwaste jug 192 can include the same type of arrangement described above(see FIG. 43) for detecting when the rinse jug 142 is securably receivedby the first housing 172. As embodied herein and shown schematically inFIG. 44 for example, the securably received detecting means for thewaste jug 192 preferably can include a micro-switch 712 which isactivated by a spring-biased plunger 714 installed in second housing206. Micro-switch 712 is electrically and/or electronically connected toa gate circuit element 47, which is electrically and/or electronicallyconnected to controller 164. When waste collection jug 192 is properlyinstalled in second housing 206, plunger 714 is depressed sufficientlyagainst the biasing spring to open the contacts of switch 712. Whenswitch 712 is opened, gate 47 sends to controller 164 a relatively highvoltage signal from the reference voltage indicated schematically inFIG. 44 as positive 5 volts. Plunger 714 and micro-switch 712 aredisposed and configured so that the contacts of switch 712 do not openunless male member 182 of connector 180 is locked into female member184. When the waste jug 192 is removed from second housing 206, theplunger 714 is released and causes switch 712 to close, which sends arelatively low voltage signal to controller 164 as the positivereference voltage leaks to ground. When controller 164 receives thesignal from micro-switch 712 indicating that waste jug 192 is not makingproper connection in second housing 206, controller 164 turns off rinsepump 150 and activates display of a message on the siderail controlpanel 168 and sounds an audible alarm to inform the operator that thewaste jug 192 has been removed or is not properly installed in secondhousing 206. When the waste jug 192 is reinstalled properly, controller164 receives the appropriate signal from micro-switch 712, and themessage and alarm are cleared.

In an alternative embodiment, the securably received detecting means forwaste jug 192 can include the same type of arrangement described abovein connection with FIG. 27 for detecting when the rinse jug 142 issecurably received by the first housing 172. A pair of electrical probes43, 45 is similarly disposed with respect to a first contact plate 190mounted on waste jug 192. As schematically shown in FIG. 9 for example,first contact plate 190 of waste jug 192 can provide an electricaldetection signal to controller 164 via a cable 213. Controller 164 thencan send a signal via cable 272 to activate a suitable embodiment of theindicator means, such as a buzzer 276 and/or an instructive LED messagelike "ATTACH HOLDING JUG" that would appear in the LED display 128mounted on control panel 168 shown in FIG. 23A. The "JUG REMOVED"message 276 shown in FIG. 23 for example, provides an alternativeembodiment of the indicator means. Thus, the indicator can inform theoperator when waste jug 192 has been removed from second housing 206, aswhen jug 192 is being emptied.

In accordance with the present invention, a means can be provided fordetecting a predetermined high level of waste liquid in the wastecollection container and providing a signal upon detecting same.Desirably, the waste jug level detecting means is configured to detectwhen the level of liquid waste has become so high as to require emptyingthe waste collection container of its contents. As embodied herein, thewaste jug level detecting means can include a liquid sensor element thatis mounted and disposed relative to waste jug 192 for detecting apredetermined level of waste liquid inside waste jug 192. The liquidsensor element for the waste jug level sensor preferably is a capacitiveproximity level sensor 740 as described above for rinse jug 142 andillustrated schematically in FIGS. 42 and 42A. In the present instance,mounting 750 is conveniently provided by the second housing 206, andcontainer 752 is conveniently provided by waste jug 192. The capacitiveproximity level sensor 740 does not contact the waste liquid insidewaste jug 192, but detects the presence of liquid by emitting anelectronic or electrical signal when the liquid comes into closeproximity of the sensor. The sensor 740 is mounted in the second housing206 at a level which will dispose the sensor's active field near the topof the waste jug 192 when the waste jug is properly installed intosecond housing 206. The sensor 740 desirably is disposed to be incontact with the outside surface of waste jug 192 when the Jug issecured in second housing 206. When the waste liquid has filled wasteJug 192 to a level that attains the requisite proximity relative to thesensor, the sensor sends a liquid proximity signal to controller 164.When controller 164 receives this high level liquid proximity signalfrom the waste jug liquid level sensor, controller 164 turns off thewaste transfer pump 194, sends a JUG FULL message to the siderailcontrol panel 168, and sounds an audible alarm to inform the operatorthat the waste jug needs to be emptied. When the waste jug 192 isremoved, emptied, and properly reinstalled into second housing 206,controller 164 clears the message and alarm.

As shown schematically in FIG. 9 for example, an alternative embodimentof the waste level detecting means can include the same type ofarrangement described above in connection with FIG. 27 for detectingwhen the rinse jug 42 has only a low level of rinse solution and needsto be refilled. However, as schematically shown in FIGS. 9 and 9A forexample, in the alternative embodiment of the high level liquiddetecting means for waste jug 192, the second contact plate 160 and itsliquid level sensor screws 41 are disposed at a high level on waste jug192 near the top of waste jug 192. Moreover, each liquid sensor screw160 in second contact plate 160 forms part of an electrical detectioncircuit that includes the second contact plate 160, a pair of probes 43,170, and first contact plate 190 and produces an electrical responsewhen the level of liquid within waste jug 192 covers at least one wasteliquid sensor screw 41 attaching second plate 160 to jug 192. Asschematically shown in FIG. 9 for example, this detection circuit 170 iselectrically connected to controller 164 via electrical cables 210 andprovides an electrical signal to controller 164 upon detection of thepredetermined high level of liquid within waste jug 192.

In addition, the waste jug's level detecting means can include a meansfor emitting a signal when the waste liquid level sensor detects apredetermined high level of fluid in waste jug 192. As embodied herein,the signal emitting means can include a buzzer and/or LED which isactivated by controller 164 on control panel 168 when controller 164receives a high liquid level detection signal from the waste jug liquidlevel sensor. In addition, controller 164 desirably is programmed sothat, operation of waste transfer pump 194 is not permitted bycontroller 164 unless controller 164 receives a signal indicating thatwaste jug 192 has been installed securely in second housing 206 withsufficient capacity to receive additional waste material via wastetransfer conduits 196.

In connection with the alternative embodiment, a means can be providedfor automatically coupling the waste jug's high liquid level detectingmeans to the controller when the waste jug is received by the secondhousing. As embodied herein, the automatic coupling means desirablyincludes substantially the same arrangement as described above for thelow liquid level detecting means of the rinse solution jug and thusincludes probes 43, 170. However, probe 170 for the waste jug isdisposed at the high level of the waste jug in order to be in a positionto contact the second contact plate 160 bearing its respective screws41. Probes 43, 170 thus are provided as a means for coupling a highliquid level sensor in communication with a signal emitting meanswherein the coupling means is automatically engageable when the secondhousing receives the waste collection container securably therein.

Each of the jugs 142, 192 disposed within their respective housings 172,206, whether beneath the bed in some embodiments (FIGS. 12 and 12A forexample) attached to the bed frame in other embodiments (FIGS. 6 and 28for example) or carried by a service cart 256 in still other embodiments(FIGS. 12, 12A, 15 and 16 for example), would be provided with meansthat would make it impossible to interchange the waste collection jug192 with the rinse solution jug 142. As embodied herein andschematically shown in FIGS. 6, 28, 29A and 29B for example, rinsesolution jug 142 has a narrower width, as evidenced by its narrowerfront and rear endwalls 145, than waste jug 192. Similarly, as shown inFIG. 28 for example, first housing 172 has a narrower slide receptacle173 than the slide receptacle 173 defined by second housing 206.Accordingly, it is impossible for waste jug 192 to be received by firsthousing 172 and equally impossible for rinse jug 142 to be received bysecond housing 206. Alternatively, each of the jugs 142, 192 could beprovided with a differently configured connector 180 and/or have thesame configuration connector 180 located in a relatively differentposition so that it would be impossible to interchange the wastecollection jug with the rinse solution jug.

In accordance with the present invention, a means can be provided forkeeping track of the amount of liquids that is collected in the wastejug. For example, these liquids could be the kind expelled by thepatient through incontinence events. As embodied herein and shownschematically in FIG. 29A for example, the expelled liquid accountingmeans can include waste collection jugs 192 formed of translucentmaterial and provided with volume graduations 214 in 50 ml increments,which indicate the liquid volume contained inside the jug. The same sortof graduations 214 (FIG. 29B) can be provided for the rinse solutionjug, which can be formed of material that is almost transparent. In thisway, each jug is provided with a visual level indicator for the liquidin the jug. An alternative embodiment of the liquid accounting means ofthe present invention, can include controller 164 programmed to accountfor liquids received by waste jug 192 and liquid provided by rinse jug142 and to provide calculated information in display 128 of controlpanel 168.

In accordance with the present invention, a means can be provided forcontrolling operation of the waste transfer pump in response to thedetection of liquid by the low level liquid sensor disposed in the wasteremoving means. The waste transfer pump control means desirably isconnected to communicate with each of the waste transfer pump, the lowlevel liquid sensor in the waste removing means, and the high levelliquid sensor in the waste jug. As embodied herein, a waste transferpump control means desirably includes controller 164 electricallyconnected to each of the waste transfer pump 194, low level liquidsensor 500 (FIG. 49A) located on holding reservoir 100, and the highliquid level sensor of, the waste jug 192. Controller 164 can beprogrammed so that when it receives a signal from the low level liquidsensor 500 indicating that moisture has reached a high enough levelinside reservoir 100 to activate sensor 500, controller 164 checks forsignals indicating that waste jug 192 is both securely connected tosecond housing 206 and has sufficient empty capacity to be able toaccept additional waste material. If and only if the latter twoconditions are detected by controller 164, controller 164 activateswaste transfer pump 194 to pump waste from holding reservoir 100 towaste collection jug 192. Controller 164 continues to operate pump 194until controller 164 receives a signal indicating that waste jug 192 isnearing capacity or that the level of waste inside holding reservoir 100is beneath low level sensor 500 and thus near outlet opening 198 ofreservoir 100. However, instead of immediately turning off wastetransfer pump 194, controller 164 can be programmed to delay aboutfifteen seconds before signaling waste transfer pump 194 to stop. Thisprevents pump 194 from cycling on and off in rapid succession.Controller 164 also is programmed so that when controller 164 receives asignal from the waste jug's high liquid level sensor indicating thatwaste jug 192 is nearing capacity, controller 164 deactivates wastetransfer pump 194 and activates an indicator on control panel 168 toalert the operator to empty waste jug 192. As shown in FIG. 23A forexample, the indicator can be provided in the form of an instructive LEDmessage such as "EMPTY HOLDING JUG" on an LED display 128.Alternatively, as shown in FIG. 23 for example, indicator 274 can beprovided in the form of an informative LED message such as "HOLDING JUGFULL."

In an alternative embodiment of the present invention, a means can beprovided for controlling operation of the waste transfer pump inresponse to the detection of liquid by the liquid detecting andsignaling means. In this alternative embodiment, the waste transfer pumpcontrol means desirably is connected to communicate with each of thewaste transfer pump, the liquid detecting and signaling means, and thehigh level liquid sensor in the waste jug. As embodied herein andschematically shown in FIG. 9 for example, a waste transfer pump controlmeans desirably includes a controller 164 electrically connected to eachof the waste transfer pump 194, the moisture detecting and signalingmeans, and the high liquid level sensor of the waste jug 192. Controller164 can be programmed so that when it receives a signal from the liquiddetection circuit indicating that moisture has entered the lower regionof drain fitting 67, controller 164 checks for signals indicating thatwaste jug 192 is both securely connected to second housing 206 and hassufficient empty capacity to be able to accept additional wastematerial. If and only if the latter two conditions are detected bycontroller 164, controller 164 activates waste transfer pump 194 to pumpwaste from holding reservoir 100 to waste collection container 192.Controller 164 continues to operate pump 194 until controller 164receives a signal indicating that waste jug 192 is nearing capacity orthat the level of waste inside holding reservoir 100 is near outletopening 198 of reservoir 100. Controller 164 also is programmed so thatwhen controller 164 receives a signal from the waste jug's high liquidlevel sensor indicating that waste jug 192 is nearing capacity,controller 164 deactivates waste transfer pump 194 and activates anindicator on control panel 168 to alert the operator to empty waste jug192.

In further accordance with the present invention, a means can beprovided for adapting the waste managing means to be carried by theframe of a patient support apparatus. The adapting means desirably issupported by the frame of the patient support apparatus and isconfigured for receiving the second portion supporting means and forbeing carried by the frame. In a presently preferred embodiment shown inFIGS. 30-34, 36, and 37 for a low air loss bed for example, the adaptingmeans desirably includes an adaptor shell 528. As shown in FIG. 32,adaptor shell 528 desirably defines a bottom surface 530 configuredsubstantially flat for being carried by a frame for a low air loss bed.In an alternative embodiment shown in FIGS. 1, 2 and 2A for a low airloss bed for example, the adapting means includes an adaptor shell 228which defines a bottom surface 230 configured substantially flat forbeing carried by a frame for a low air loss bed. However, a differentframe could form part of a conventional hospital bed with anarticulatable frame, a wheelchair, a hospital emergency room treatmenttable, or the like, and bottom surface 230, 530 of respective adaptorshell 228, 528 would be configured to adapt to such different frame.

As shown in FIGS. 2, 30, 32 and 36 for example, each respective adaptorshell 228, 528 further generally defines at a central location, arespective receiving opening 232, 532. Receiving opening 232, 532desirably is defined with a configuration for securingly andsupportingly receiving the waste managing means such that the supportingmeans of the waste managing means is disposed substantially coplanarwith the patient support surface of the patient support apparatus. In alow air loss bed 30 as illustrated in FIG. 1 for example, this patientsupport surface is defined by the upper surfaces 46 of sacks 44.Accordingly, as shown in FIGS. 2 and 2A for example, base portion 54 ofsupport bladder 48 is received by receiving opening 232 of adaptor shell228, which securely receives this support member. Similarly, as shown inFIG. 32 for example, base portion 554 of support bladder 548 is receivedby receiving opening 532 of adaptor shell 528, which securely receivesthis support member.

In a presently preferred embodiment of the waste managing means shown inFIGS. 30-34 and 36-37, adaptor shell 528 desirably is formed by twotypes of underlying inflatable support cushions 509, 510 and two typesof peripheral containment cushions 511, 512. The underlying inflatablesupport cushions 509, 510 are disposed beneath the second portionsupporting means such as bladder 548 or 48. The peripheral containmentcushions 511, 512 are disposed around the periphery of the secondportion supporting means such as bladder 548 or 48 and provideperipheral containment of bladder 548 or 48. Thus, as shown in FIG. 30,these four different types of inflatable, low air loss-type cushions509, 510, 511, 512 combine to define receiving opening 532. Each of thefour types of cushions desirably is a half-height cushion such that twocushions stacked atop each other have a combined height that is equal tothe normal height of a conventional low air loss static support sack 44or turning sack 270 of a low air loss bed.

As shown in FIG. 36, the two different types of underlying supportcushions include a pair of centrally disposed and adjacent slottedcushions 509. As shown in FIGS. 34, 36 and 37, each slotted cushion 509defines a centrally disposed slot 513 therethrough that elongates in adirection transverse to the length of slotted cushion 509. As shown inFIG. 33, slot 513 functions as a pass-through opening to provide accessfor drain fitting 67 and/or waste removal conduit 98. As shown in FIG.37, each slotted cushion 509 defines an upper exterior panel 565 and alower exterior panel 567. Lower exterior panel 567 defines an elongatedopening 568, and upper exterior panel 565 defines an elongated opening569 configured and disposed in registry with elongated opening 568defined in lower exterior panel 567. A web 514 extends between elongatedopenings 568, 569 defining opposite ends of the pass-through openingformed by slot 513. To either side of the web 514 (dashed line in FIG.34) which forms the slot 513 of each slotted cushion 509, there extendsa pair of elongated dividing webs 515 (dashed line in FIG. 34)symmetrically disposed to divide slotted cushion 509 into threeintercommunicating chambers 516. As shown in FIG. 37, a first pair ofair supply connections 517 is disposed through the lower exterior panelof 567 cushion 509 and at a location that is closer to slot web 514 thanto the end of cushion 509. Each first air supply connection 517 definesa first air supply opening 518. Mirroring the first air supplyconnections 517 and openings 518 are a pair of second air supplyconnections 519 and respective air supply openings 520 (only one shownin dashed line is visible in the view shown in FIG. 37) disposed on theopposite side of slot web 514 of slotted cushion 509. The oppositeexterior end surfaces of each cushion 509 includes attachment means suchas snaps 521. As shown in FIG. 30, these snaps 521 attach to sideattachment panels 522 which help hold the slotted cushions 509 and thehalf-height turning cushions 510 (described below) together.

As shown in FIGS. 30, 33 and 36, a pair of half-height turning cushions510 is disposed adjacent each of the two centrally disposed slottedcushions 509. As shown in longitudinal cross-section in FIG. 31, eachhalf-height turning cushion 510 is configured in a manner similar tothat shown in FIG. 8 and in U.S. Pat. No. 4,949,414 to Thomas et al. Themain difference between the half-height cushions 510 and the turningcushions shown in Thomas et al and in FIG. 8, is the height of theformer being half of the height of the latter. As shown in FIG. 31, eachhalf-height cushion 510 includes a pair of inflatable chambers disposedopposite one another and separated by a diagonally extending web 575. Asshown in FIGS. 31 and 32, each of the oppositely disposed chambers isfurther defined by an end chamber 525 and an intermediate chamber 570separated from end chamber 525 by a web 573. An air exchange opening 574is defined through separation web 573 and permits air to communicatebetween intermediate chamber 570 and end chamber 525. Air supply tubes524 communicate with each end chamber 525 of the half-height turningcushions 510. Diagonally disposed web 575 separates the two oppositelydisposed chambers and forms a common wall of the respective intermediatechambers 570. In this way the oppositely disposed chambers areconfigured to be separately inflated and deflated for selectivelyinflating at least one inflatable chamber while deflating the oppositelydisposed chamber, thereby changing the height of one of the pair ofoppositely disposed chambers with respect to the height of the other ofthe oppositely disposed chambers.

As shown in FIG. 30, a peripheral side containment cushion 511 isdisposed at each opposite side of receiving opening 532, and aperipheral end containment cushion 512 is disposed at each opposite endof receiving opening 532. As shown in FIGS. 30 and 39, peripheralcontainment cushions 511, 512 desirably are inflated with pressurizedair and join together to form a continuous border around support bladder548 or 48. A means is provided to attach the adjacently disposed ends ofeach side peripheral containment cushion 511 with each end peripheralcontainment cushion 512. As shown in FIG. 30, the end of each sideperipheral containment cushion 511 is provided with snaps 529 forattachment to mating snaps 529 disposed near the end of the inner sideportion of end peripheral containment cushion 512. In an alternativeembodiment, hook-and-loop substrates can be used instead of snaps 529.Moreover, as shown in FIG. 36, a plurality of hook-and-loop substrates590 is provided near the opposite edges of upper exterior panel 565 ofeach slotted cushion 509. Though not visible in the view shown in FIG.30, the bottom panel of each side peripheral containment cushion 511 isprovided with mating hook-and-loop substrates 590 which are disposed toengage the substrates 590 of slotted cushions 509 and anchor sidecushions 511 to slotted cushions 509. Similarly, as shown in FIG. 36, aplurality of hook-and-loop substrates 590 is provided along the lengthof the upper exterior panel of each half-height turning cushion 510 thatis disposed beneath each end peripheral containment cushion 512. Asshown in FIG. 36, the bottom panel of each end peripheral containmentcushion 512 is provided with mating hook-and-loop substrates 590 whichare disposed to engage the substrates 590 of half-height turningcushions 510 and anchor end cushions 512 to turning cushions 510.

As shown in FIG. 30, an elongated strip of hook-and-loop substrate 531is attached to the lower free edge of basin member 562, which isconfigured to surround three of the elongated side surfaces of sideperipheral containment cushions 511. Another elongated strip ofhook-and-loop substrate 531 is attached near the upper free edge of sideattachment panel 522 and disposed to be in registry with substrate 531of basin member 562. Engagement of the respective substrates 531 servesto anchor basin member 562 to side attachment panels 522. Moreover, asshown in FIGS. 30 and 32, side panels 522 and 523 are provided with arow of snaps 592 that are arranged to be in registry with a row ofmating snaps 593 disposed along a flange 594 of the frame of the patientsupport apparatus. In addition, as shown in FIG. 33, basin member 562has a pair of downwardly extending flap portions that cover theelongated exterior sides of end peripheral containment cushions 512 andare wedged between cushions 512 and full-height turning sacks 270.

An alternative embodiment of the waste managing means designed to beused in a low air loss bed is shown in FIGS. 1 and 2 as an adaptor shell228 that is formed by a plurality of individual inflatable cushions 234having a generally U-shaped external configuration defining a receivingopening 232. Each oppositely disposed leg portion 236 of each cushion234 stands the same ten inches tall as the normal height of aconventional sack 44 of a low air loss bed. However, the intermediatebase portion of each U-shaped cushion 234 stands only about five to fiveand one half inches high as opposed to being 10 inches high as a normalheight sack 44 of a low air loss bed. The interior surfaces of the legs236 of the U-shaped cushions 234 cooperate with the base portion of theU-shaped cushions to define receiving opening 232. As schematicallyshown in FIGS. 1 and 2 for example, adaptor shell 228 also can include aconventional height air sack 44 disposed at each opposite end of theplurality of side-by-side cushions 234 and further defining receivingopening 232.

As shown in FIG. 2 for example, an elongated slot 237 can be defined inthe intermediate portion of a centrally located cushion 235, which Isabout three times wider than adaptor shell cushions 234 located onopposite sides of central cushion 235 of adaptor shell 228. Slot 237provides access for drain fitting 67 and/or waste removal conduit 98 toprovide communication between holding reservoir 100 and drain opening 66defined in floor 64 of basin member 62. In addition, the externalsurfaces of the legs 236 of the U-shaped configuration of each cushion234 or 235 define opposed externally facing peripheral walls 238.

Desirably, cushions 234, 235, 509, 510, 511, 512 are entirely formed ofnylon twill material with a urethane film laminated to it. Such materialcan be heat sealed to form an air tight enclosure, which is inflatablewith pressurized air. Alternatively, a fabric coated withpolytetrafluoroethylene (such as TEFLON™) can be used to form cushions234, 235, 509, 510, 511, 512 if such material is mechanically sealed, asby sewing for example. Each cushion 234, 235, 509, 510, 511, 512desirably is provided with inlet fittings (not shown for each cushion)so that it can be inflated with air using the air supply system of a lowair loss bed or an independent air supply system.

Additionally, an alternative embodiment of the adaptor shell 228, 528can be formed of a flexible and resilient foam material for example, orof another flexible material capable of providing the proper supportivereceiving configuration for the waste managing means.

FIG. 39 presents a schematic representation of the air supply conduitswhich provide pressurized air to a presently preferred embodiment of thewaste managing means disposed in a low air loss bed which have fivegroupings of low air loss sacks, each grouping of sacks being arrangedin one of five separate pressure zones 1-5. Ordinarily, the sacks inzone 1 support the patient's head, and the sacks in zone 5 support thepatient's feet. As schematically shown in FIG. 39, a blower 304 suppliespressurized air to a multi-valve manifold 306, which includes fivepressure control valves (represented by the aligned squares labelledrespectively, Z1, Z2, Z3, Z4, and Z5).

Each pressure control valve Z1, Z2, Z3, Z4, and Z5 has a vent port (notshown in FIG. 39) communicating with the atmosphere, an inlet port andan outlet port. When a CPR procedure must be performed, each pressurecontrol valve Z1, Z2, Z3, Z4, and Z5 can be configured to connect itsoutlet port with its vent port and thereby provide an air flow path toeffect deflation of all of the inflated components of the apparatus sothat the patient will rest on a rigid support manifold that carries theinflated components.

Each pressure control valve Z1, Z2, Z3, Z4, and Z5 is connected to theinlet of a corresponding air flow diverter valve, which is representedschematically in FIG. 39 by a circle circumscribing the same label, Z1,Z2, Z3, Z4, and Z5. Each pressure control valve Z1, Z2, Z3, Z4, Z5 andcorresponding air flow diverter valve Z1, Z2, Z3, Z4, Z5 is controlledby controller 164 (not shown in FIG. 39). The arrows schematicallyindicated the flow of air through valves Z1, Z2, Z3, Z4 and Z5 in eachof FIGS. 41(a), 41(b), 41(c), 41(d), 41(e) and 41(f) as explained below.

FIGS. 41(a), 41(b), and 41(c) schematically represent each of air flowdiverter valves Z1, Z2, and Z5 configured to supply air to the sacks 44for supporting the patient in each of three different respectiveorientations, namely, patient turning right [FIG. 41(a)], patientturning left [FIG. 41(b)], and patient centered [FIG. 41(c)]. Similarly,FIGS. 41(d), 41(e), and 41(f) schematically represent each of air flowdiverter valves Z3 and Z4 configured to supply air to the sacks 44 forsupporting the patient in each of three different respectiveorientations, namely, patient centered [FIG. 41(d)], turning left [FIG.41(e)], and turning right [FIG. 41(f)]. As schematically shown in FIG.41, each air flow diverter valve Z1, Z2, Z5 is a four-port, three-waydiverter valve having a magnet 706 which activates Hall-effect sensors(not shown) to indicate the configuration of the valve to controller 164(not shown). Each air flow diverter valve Z1, Z2, Z5 has a vent port 736communicating with the atmosphere, a left outlet port 718, a rightoutlet port 719, and an inlet port 717 communicating with the outletport of its corresponding pressure control valve Z1, Z2, Z5. Each airflow diverter valve Z1, Z2, Z5 can be configured to connect its inlet717 to both its left outlet 718 and right outlet 719. Each air flowdiverter valve Z1, Z2, Z5 can be configured to connect its inlet 717 toone of its left outlet 718 or right outlet 719 while connecting its ventport 736 to the other of its left outlet 718 or right outlet 719. Asschematically shown in FIGS. 39 and 41(a), when the patient is beingturned to the right, each of air flow diverter valves Z1, Z2, and Z5 isconfigured so that a respective left manifold 724, 726, 732 is connectedto the valve's inlet 717 via the valve's left outlet 718, and arespective right manifold 725, 727, 733 is connected in communicationwith the valve's vent port 736 via the valve's right outlet 719. Asschematically shown in FIGS. 39 and 41(b), when the patient is beingturned to the left, each of air flow diverter valves Z1, Z2, and Z5 isconfigured so that a respective left manifold 724, 726, 732 is connectedto the valve's vent port 736 via the valve's left outlet 718, and arespective right manifold 725, 727, 733 is connected in communicationwith the valve's inlet 717 via the valve's right outlet 719. Asschematically shown in FIGS. 39 and 41(c), when the patient is centered,each of air flow diverter valves Z1, Z2, and Z5 is configured so that arespective left manifold 724, 726, 732 is connected to the valve's inlet717 via the valve's left outlet 718, and a respective right manifold725, 727, 733 is connected in communication with the valve's inlet 717via the valve's right outlet 719.

As schematically shown in FIG. 41, each air flow diverter valve Z3 andZ4 is a four-port, two-way diverter valve, which can be configured toconnect its inlet port 720 to both its left outlet 721 and right outlet722 or to connect its vent port 723 to both its left outlet 721 andright outlet 722. As schematically shown in FIGS. 39 and 41(d), when thepatient is centered, each of air flow diverter valves Z3 and Z4 isconfigured so that a respective left manifold 728, 730 is connected tothe valve's inlet 720 via the valve's left outlet 721, and a respectiveright manifold 729, 731 is connected in communication with the valve'sinlet 720 via the valve's right outlet 722. As schematically shown inFIGS. 39 and 41(e), when the patient is being turned to the left, eachof air flow diverter valves Z3 and Z4 is configured so that a respectiveleft manifold 728, 730 is connected to the valve's vent port 723 via thevalve's left outlet 721, and a respective right manifold 729, 731 isconnected in communication with the valve's vent port 723 via thevalve's right outlet 722. As schematically shown in FIGS. 39 and 41(f),when the patient is being turned to the right, each of air flow divertervalves Z3 and Z4 is configured so that a respective left manifold 728,730 is connected to the valve's vent port 723 via the valve's leftoutlet 721, and a respective right manifold 729, 731 is connected incommunication with the valve's vent port 723 via the valve's rightoutlet 722.

As schematically shown in FIG. 39, one of the air supply openings ofeach of the air sacks shown in Zone 1 is connected to a first left sidemanifold 724, which is connected to the left outlet 718 of firstdiverter valve Z1. Similarly, the other of the air supply openings ofeach of the air sacks shown in Zone 1 is connected to a first right sidemanifold 725, which is connected to the right outlet 719 of firstdiverter valve Z1. As schematically shown in FIG. 39, Zone 1 contains asiamese bag 269 and a full-height turning bag 270 (such as shown in FIG.8).

As shown in FIG. 48, siamese bag 269 has a pair of full-height bagenvelopes 760, 761 joined together and communicating with one another bya pair of air flow communication slots 762,763. Each communication slot762, 763 is formed by joining commonly registered openings in theadjacent side walls of the envelopes 760, 761. Each envelope 760, 761 isdivided by a diagonally extending web 764, 765. The diagonal webs 764,765 of both envelopes 760, 761 are disposed parallel to each other. Oneof the slots 762 provides air flow communication between the respectiveupper chambers 766, 767 of the two envelopes 760, 761, while the otherslot 763 provides air flow communication between the respective thelower chambers 768, 769 of the two envelopes. One of the envelopes 761has a pair of spaced apart air flow supply fittings 770, 771 surroundinga respective pair of air supply openings formed through the bottom wall772 of the envelope 761. The air supply opening corresponding to fitting771 is disposed at one end of envelope 761 on one side of diagonal web765, while the air supply opening corresponding to fitting 770 isdisposed at the other end of envelope 761 on the other side of diagonalweb 765. As shown in FIG. 39, each air supply fitting 770, 771 can bereceived into either first left side manifold 724 or first right sidemanifold 725. As shown in FIG. 39, the envelope 761 with air supplyfittings 770, 771 is desirably disposed as the second envelope from theend of, Zone 1 rather than the outermost envelope. In thisconfiguration, the air supply conduits that carry pressurized air to themanifolds 724, 725 to supply air to siamese bag 269, are kept away fromthe free edge of the head section, leaving this space available to houseother components of the patient support apparatus.

As schematically shown in FIG. 39, one of the air supply openings ofeach of the air sacks shown in Zone 2 is connected to a second left sidemanifold 726, which is connected to the left outlet 718 of seconddiverter valve Z2. Similarly, the other of the air supply openings ofeach of the air sacks shown in Zone 2 is connected to a second rightside manifold 727, which is connected to the right outlet 719 of seconddiverter valve Z2. As schematically shown in FIG. 39, Zone 2 containsone full-height turning bag 270 (such as shown in FIG. 8) and twohalf-height turning bags 510 (such as shown in FIGS. 30, 31, 33 and 36).

As schematically shown in FIG. 39, in addition to supplying pressurizedair to second flow diverter valve Z2, second pressure control valve Z2also supplies pressurized air via air supply conduits 534, 535 (such asshown in FIG. 36) to one of peripheral end containment cushions 512 andto lower torso section Z (see FIG. 19 for example) of support bladder548.

As schematically shown in FIG. 39, third pressure control valve Z3controls the flow of air supplied to the inlet 720 of third divertervalve Z3. Two of the air supply openings of slotted cushion 509 shown inZone 3 are connected to a third left side manifold 728, which isconnected to the left outlet 721 of third diverter valve Z3. Similarly,the other two the air supply openings of slotted cushion 509 shown inZone 3 are connected to a third right side manifold 729, which isconnected to the right outlet 722 of third diverter valve Z3. Inaddition, third pressure control valve Z3 controls the flow of airsupplied via air supply conduits 537, 538 (such as shown in FIG. 36) tothe two side peripheral support cushions 511 and to buttocks section Y(see FIG. 19 for example) of support bladder 548.

As schematically shown in FIG. 39, fourth pressure control valve Z4controls the flow of air supplied to the inlet 720 of fourth divertervalve Z4. Two of the air supply openings of slotted cushion 509 shown inZone 4 are connected to a fourth left side manifold 730, which isconnected to the left outlet 721 of fourth diverter valve Z4. Similarly,the other two the air supply openings of slotted cushion 509 shown inZone 4 are connected to a fourth right side manifold 731, which isconnected to the right outlet 722 of fourth diverter valve Z4. Inaddition to supplying pressurized air to fourth flow diverter valve Z4,fourth pressure control valve Z4 also supplies pressurized air via airsupply conduits 540, 541 (such as shown in FIG. 36) to one of peripheralend containment cushions 512 and to calf section X (see FIG. 19 forexample) of support bladder 548.

As schematically shown in FIG. 39, one of the air supply openings ofeach of the air sacks shown in Zone 5 is connected to a fifth left sidemanifold 732, which is connected to the left outlet 718 of fifthdiverter valve Z5. Similarly, the other of the air supply openings ofeach of the air sacks shown in Zone 5 is connected to a fifth right sidemanifold 733, which is connected to the right outlet 719 of fifthdiverter valve Z5. Zone 5 contains two half-height turning bags 510(such as shown in FIGS. 30, 31, 33 and 36) and four full-height turningbags 270 (such as shown in FIG. 8).

Thus, at least a first section of adaptor shell 228, 528 can beconfigured to be inflatable with a gas. Because the means for supplyingpressurized air to cushions 234, 509, 510, 511, 512 and support bladder48, 548 can be easily adapted to the air supply system that exists tosupply pressurized air to the support sacks 44 and/or 270 of a low airloss bed, the waste managing means of the present invention is easilyretrofitted to existing low air loss beds.

As embodied herein and schematically shown in FIGS. 1 and 1A forexample, a means for carrying the waste managing means can include atray 242. Tray 242 is located at about the midpoint of lower frame 34and desirably can carry four 17 Amp-Hr batteries 252, which providepower to blower 304 when the normal power supplied from wall outletsbecomes unavailable. Tray 242 has a pair of opposed sidewalls 244 whichextend vertically from a tray bottom 246. The free edge of each sidewallis configured to form a flange 248 disposed perpendicularly to sidewall244 and parallel to tray bottom 246. The height of each sidewall 244 isdesirably configured to be at least as high as the height of frame rails38 of lower frame 34, and can be higher as shown in FIG. 1 for example.The width of each flange 248 desirably is configured to the samedimensions as the width of frame rails 38 of lower frame 34. Flanges 248rest atop frame rails 38 of lower frame 34, which carries tray 242.

As embodied herein and schematically shown in FIGS. 1, 6, 10 and 28 forexample, the means for carrying the waste managing means can furtherinclude a foot-of-the-bed-mounted container 254. Foot-mounted container254 desirably includes an enclosure and a base plate mounted on slideswhich enable the base plate to slide horizontally in and out from withinthe enclosure. Holding reservoir 100 and vacuum blower 102 are desirablymounted on and carried atop the base plate of foot-mounted container254.

Alternatively, and as shown in FIGS. 12, 12A, 15, and 16 for example,the means for carrying the waste managing means can include a mobileservice cart 256. As schematically shown in FIGS. 15 and 16 for example,an upright mobile service cart 256 can include an upright frame 258, ahandle 260 and wheels 262. As schematically shown in FIGS. 12 and 12Afor example, an undercarriage service cart 256 has a low profile portion264 that can be slid beneath one end of the frame of a bed and iscarried by larger support wheels 266 disposed at one end and smallerwheels 268 disposed at the low profile end.

In still further accordance with the present invention, a means can beprovided for turning the patient to facilitate cleansing of the patientafter an incontinence event for example. Desirably, the apparatus of thepresent invention is capable of turning the patient automatically about20 degrees from the horizontal plane in order to enable a single memberof the hospital staff to turn the patient the rest of the way to thepatient's side to facilitate cleansing of the patient with vacuum wand104. In addition, the turning means desirably is carried by the frame ofthe patient support apparatus. As embodied herein and shownschematically in FIGS. 2, 2A and 30 for example, the turning meansdesirably includes filter sheet 80, 580 described above and used toperform the function of a drawing sheet. However, as embodied herein andshown in FIGS. 8, 31, 39 and 48 for example, the turning means alsodesirably includes a plurality of specially configured full-heightturning sacks 269, 270 and half-height turning sacks 510, which areprovided with pressurized air in one or more configurations under thecontrol of a controller 164. Turning sacks 269, 270, 510 assist theturning operation by automatically, and without the effort of hospitalstaff, turning the patient about 20 degrees toward one side or theother. This automatic partial turning of the patient enables a singlenurse or other member of the hospital staff to completely turn thepatient entirely to the patient's side by pulling on filter sheet 80,580.

As schematically shown in FIGS. 8, 31 and 48 for example, the operativeturning sacks 270, 510, 269, respectively, can be configured as theso-called RESTCUE® type sacks disclosed in U.S. Pat. No. 4,949,414 toThomas et al, the disclosure of which patent is hereby incorporated intothis patent application by this reference. In an alternative embodimentshown in FIG. 8, a plurality of full-height turning sacks 270 can bealternated with a plurality of conventional low air loss bed supportsacks 44 such as the so-called FLEXICAIR® sacks disclosed in U.S. Pat.Nos. 4,745,647 to Goodwin; 4,768,249 to; and 4,949.413 to Goodwin, thedisclosures of which patents are hereby incorporated into this patentapplication by this reference.

In the presently preferred embodiment shown schematically in FIGS. 31,39 and 41 for example, the means for controlling the air supplied to theturning means includes a plurality of air flow diverter valves Z1, Z2,Z3, Z4, Z5 through which low pressure air is selectively supplied tofull-height turning sacks 269, 270 and half-height turning sacks 510 viarespective left side manifolds 724, 726, 728, 732, and respective rightside manifolds 725, 727, 733. Each air flow diverter valve Z1, Z2, Z3,Z4, Z5 is motor operated under the control of controller 164 and can besupplied with low pressure air from blower 304 and multi-valve manifold306, which also are controlled by controller 164. As shown schematicallyin FIG. 41, diverter valves Z1, Z2, and Z5 are similarly configured foreach of the three operating modes, namely, patient centered, patientturning left, and patient turning right. In addition, diverter valves Z3and Z4 are similarly configured for each of these three operating modes.To assist turning the patient toward the left side of the patientsupport surface, as shown schematically in FIG. 41, each diverter valveZ1, Z2, and Z5 can be configured to supply low pressure air to the rightsides of turning sacks 269, 270, 510 while allowing the left sides ofsacks 269, 270, 510 to vent to atmosphere via the vent port 736 of eachdiverter valve Z1, Z2, and Z5. Each diverter valve Z3 and Z4 can beconfigured to vent slotted cushions 509 to atmosphere via the respectivevent port 723 of diverter valves Z3 and Z4. Alternatively, to assistturning the patient toward the right side of the patient supportsurface, each diverter valve Z1, Z2, and Z5 can be configured to supplylow pressure air to the left sides of turning sacks 270, 510 whileallowing the right sides of sacks 270, 510 to vent to atmosphere via thevent port 736 of each diverter valve Z1, Z2, and Z5. Again, eachdiverter valve Z3 and Z4 can be configured to vent slotted cushions 509to atmosphere via the respective vent port 723 of diverter valves Z3 andZ4. Desirably, adjacent turning sacks are arranged and oriented alongthe length of the patient support apparatus so that the position of thediagonal web (designated 775 in FIG. 8 for full-height sack 270 and 575in FIG. 31 for half-height sack 510) of each turning sack 269, 270, 510is alternated with each adjacent turning sack so that for each pair ofadjacent turning sacks, the greater volume of the upper intermediatechamber is alternately disposed between the right side of the patientsupport apparatus and the left side of the patient support apparatus.

Furthermore, each control panel 168 desirably contains controls andindicators for turning the patient using the turning sacks 270, 510. Asembodied herein and shown schematically in FIGS. 9, 23 and 23A forexample, a control button 286 causes controller 164 to implement turningof the patient to the right and to activate an indicator 288, whichindicates that the patient has been turned to the right side of thesupport surface. Similarly, a control button 290 causes controller 164to implement turning of the patient to the left and to activate anindicator 292, which indicates that the patient has been turned to theleft side of the support surface. In addition, a control button 294causes controller 164 to implement turning of the patient back to thecenter from either the left or the right side of the support surface andto activate an indicator 296, which indicates that the patient has beenturned back to the center portion of the support surface.

When the operator presses the left turn or right turn button, controller164 activates the diverter valve motors to configure the respectivediverter valves Z1, Z2, Z3, Z4, and Z5 to provide air from the airsupply means, such as blower 304 and multi-valve manifold 306, to theturning device such as turning bags 269 (FIG. 48), 270 (FIGS. 8 and 13)and 510 (FIGS. 30 and 31) and slotted cushions 509 in the mannerdescribed above. Controller 164 also sends a control signal to activatethe proper turning indicator 288, 292, 296.

The turning device remains in the turned condition until the operatorpresses center button 294. When center button 294 is pressed, controller164 sends a signal to reconfigure (as shown schematically in FIG. 41)air flow diverter valves Z1, Z2, Z3, Z4, Z5 to provide air to both theleft and right sides of turning sacks 269, 270, 510 and to slottedcushions 509. At the same time, controller 164 sends a signal to the airsupply source, such as blower 304, to inflate both sides of sacks 269,270, 510 to a maximum inflation condition for a period of one minute inorder to assist bringing the patient back to the center position. Afterthe one minute maximum inflation, controller 164 signals blower 304 tooperate in a manner that supplies the normal air pressure to supportsacks 269, 270, 510. In addition, controller 164 activates centerindicator 296 on control panel 168 to indicate that the system isreturning the patient to the center position. Controller 164 returnscenter indicator 296 to the off condition as soon as the air supplysource returns sacks 269, 270, 510 to a normal pressurized condition.

In an alternative embodiment shown schematically in FIGS. 8 and 13 forexample, the means for controlling the air supplied to the turning meansincludes a pair of air flow diverter valves 300, 302 through which lowpressure air is selectively supplied to full-height turning sacks 270via air flow conduits 176, 177, 178, 179. Conduits 177, 179 are providedwith an accordion section 185 at each location where conduits 177, 179pass across an articulating section of the frame carrying conduits 177,179. A first diverter valve 300 is a 4-port, 2-way valve, while a seconddiverter valve 302 is a 16-port, 2-way valve. Both diverter valves 300,302 are motor operated under the control of controller 164 and can besupplied with low pressure air from a blower 304 and a multi-valvemanifold 306, which also are controlled by controller 164. Firstdiverter valve 300 can be configured (solid diagonal line in FIG. 13) tosupply low pressure air to the right sides of turning sacks 270 whileconnecting the left sides of sacks 270 to atmosphere via a vent port308. Alternatively, first diverter valve 300 can be configured (dasheddiagonal line in FIG. 13) to supply low pressure air to the left sidesof turning sacks 270 while connecting the right sides of sacks 270 toatmosphere via vent port 308. Second diverter valve 302 can beconfigured (solid diagonal line in FIG. 13) to supply low pressure airto the turning sacks 270, 510 through turning sack port 309 and firstdiverter valve 300, while simultaneously connecting the support sacks44, which as shown in FIG. 8 are disposed alternately between each pairof turning sacks 270, to atmosphere via five vent ports 310, one ventport 310 for each zone group of support sacks in bed 30, and fivesupport sack ports 312. The air flow conduits used to supply air to thesupport sacks 44 are different than conduits 176, 177, 178, 179 shown inFIG. 13 and are not shown in FIG. 13. In a second alternativeconfiguration (dashed diagonal line in FIG. 13) of second diverter valve302, low pressure air is supplied from blower 304 via five support sackports 312 to the support sacks 44, which as shown in FIG. 8 are disposedalternately between each pair of turning sacks 270, while connecting theturning sacks 270 through first diverter valve 300 and vent ports 310 toatmosphere.

In the alternative embodiment schematically shown in FIG. 13 forexample, controller 164 desirably is preprogrammed to use both divertervalves 300, 302 to control the air supplied to the two groups (turning270, 510 and support 44) of air sacks forming the patient turning means.During the turning operation, one of the two groups (turning sacks 270for example) of air sacks is either completely filled or being filled,while the other of the two groups (support sacks 44 for example) of airsacks is either completely empty or being deflated. Controller 164desirably is preprogrammed so that inflation of the fully deflated groupof air sacks begins to occur at the same time as the onset of deflationof the fully inflated group of air sacks begins to occur.

When the operator presses the left turn or right turn button in thisalternative embodiment of FIG. 13, controller 164 activates a divertervalve motor to configure the second diverter valve 302 to provide airfrom the air supply means, such as blower 304 and multi-valve manifold306, to the turning device such as turning bags 270 (FIGS. 8 and 13) and510 (FIGS. 30 and 31). Controller 164 also sends a control signal toactivate the proper turning indicator 288, 292, 296 as well asconfiguring first diverter valve 300 to divert air into the proper side,left or right, of turning sacks 270, 510.

The turning device of the FIG. 13 embodiment remains in the turnedcondition until the operator presses center button 294. When centerbutton 294 is pressed, controller 164 sends a signal to reconfigure (asshown schematically by the dashed diagonal line in FIG. 13) seconddiverter valve 302 to allow air from the heretofore inflated side ofturning sacks 270, 510 to exhaust through vent ports 310. At the sametime, controller 164 sends a signal to the supply source, such as blower304, to inflate support sacks 44 to a maximum inflation condition for aperiod of one minute in order to assist bringing the patient back to thecenter position. After the one minute maximum inflation, controller 164signals blower 304 to operate in a manner that supplies the normal airpressure to support sacks 44. In addition, controller 164 activatescenter indicator 296 on control panel 168 to indicate that the system isreturning the patient to the center position. Controller 164 returnscenter indicator 296 to the off condition as soon as the air supplysource returns sacks 44 to a normal pressurized condition.

At articulation angles of 30 degrees and higher, it becomes undesirableto permit the patient turning means to be activated. Accordingly,controller 164 is preprogrammed to prohibit initiation of the turningoperation if the angle of the head section of the bed is elevated above30° from the horizontal. Moreover, each control panel 168 desirablyincludes a warning indicator actuatable by controller 164 to alert theoperator when the patient support surface has been articulated to atleast an angle of 30 degrees above the horizontal.

In accordance with the present invention, means can be provided toprevent operation of the patient turning means unless the side rail isin the raised position in the patient support system. As embodied hereinand schematically shown in dashed line in FIG. 1 for example, the meansfor preventing operation of the turning means while the side rail is inthe lowered position desirably includes an appropriately disposed andwired side rail interlock microswitch 169 which sends a signal tocontroller 164 when side rail 167 is locked in the upright position(schematically shown in FIG. 1 for example). Controller 164 ispreprogrammed to prevent activation of the patient turning means unlessthe signal received from each microswitch 169 indicates that the siderails 167 are locked in the upright position. In addition, controller164 activates a warning indicator on control panels 168 to alert theoperator when the side rail is oriented in the lowered position and theoperator is attempting to activate the patient turning means. As shownin FIG. 23A for example, the indicator can be provided in the form of aninstructive message such as "RAISE RIGHT SIDE RAIL" on an LED display128. In an alternative embodiment shown in FIG. 23 for example, theindicator can be provided in the form of an informative message 165 suchas "SIDE RAIL DOWN" on an LED display.

In accordance with the present invention, a means can be provided forcounting the number of incontinence events that occur during a givenperiod of time. As embodied herein and shown schematically in FIG. 9 forexample, the counting means can include controller 164 suitablyprogrammed to keep account of the number of signals received from themoisture detecting and signaling means during a given interval of time.

As embodied herein, controller 164 desirably provides the capability forautomatically controlling various electrically actuatable devices suchas rinse pump 150, waste transfer pump 194, vacuum blower 102, and thevarious valves Z1, Z2, Z3, Z4, Z5, 300, 302, 306 provided for theinflatable sacks 44, 269, 270, cushions 234 or 509, 510, 511, 512 andthe support bladder 48 or 548. Controller 164 also desirably providesinterfaces between various components of the system and the controlpanel's visual indicators that allow the operator to monitor the statusof the system. In this regard, controller 164 desirably automaticallymonitors existing functions of the patient support apparatus, monitorsthe occurrence of events which create waste materials that need to beremoved from the patient environment and contained for disposal, andmonitors liquid volume levels in the rinse jug 142, holding reservoir100, and waste collection jug 192.

Whenever a CPR procedure must be performed, controller 164 sends theappropriate signals to stop whatever operation the waste managementapparatus was performing. For example, controller 164 removes power fromwaste transfer pump 194, vacuum blower 102, and rinse pump 150. Inaddition, controller 164 also configures pressure control valves Z1, Z2,Z3, Z4, Z5 (FIG. 39) to connect their outlet ports to their vent portsand configures corresponding air flow diverter valves Z1, Z2, Z3, Z4, Z5as necessary to deflate turning sacks 269, 270, 510, support bladder 48or 548 and adaptor shell 228 or 528. Furthermore, notwithstandingwhether a CPR procedure is being performed, if the waste managementapparatus of the present invention is provided in conjunction with anarticulatable low air loss bed, controller 164 desirably is programmedto turn off vacuum blower 102 and rinse pump 150 during botharticulation and raising or lowering of the bed, in order to preventpower circuit overloads.

What is claimed is:
 1. Apparatus for managing waste from the treatment and/or care and maintenance of a patient who is supported at least as to a first portion of the patient's body on a support surface of a patient support system, the apparatus comprising:a) means for supporting at least a second portion of the body of the patient, said second patient body portion supporting means defining an inflatable first surface configured and disposed substantially coplanar with the support surface of the patient support system; and b) means for catching waste,i) said waste catching means being supported by said second patient body portion supporting means so as to be disposed between the patient and said second patient body portion supporting means.
 2. An apparatus as in claim 1, further comprising:c) means for removing the waste from said catching means, said removing means being disposed in communication with said catching means.
 3. An apparatus as in claim 2, further comprising:d) means for collecting the waste removed from said catching means by said removing means, said collecting means being disposed in communication with said removing means.
 4. An apparatus as in claim 2, wherein:e) said removing means includes:i) at least one waste removal conduit connected in communication with said catching means, ii) a holding reservoir connected to said waste removal conduit, and iii) a vacuum blower disposed for creating a suction force in said waste removal conduit.
 5. An apparatus as in claim 4, wherein:f) said removing means further includes:i) a drain fitting configured and disposed to permit transfer of fluid waste between said waste removal conduit and said catching means.
 6. An apparatus as in claim 2, wherein:e) said catching means includes a liquid impermeable basin member, said basin member including at least one drain opening; and f) said removing means includes:i) at least one waste removal conduit connected in communication with said at least one drain opening of said basin member, ii) a holding reservoir connected to said waste removal conduit, and iii) a vacuum blower disposed for creating a suction force in said waste removal conduit.
 7. An apparatus as in claim 6, further comprising:e) means for detecting a predetermined level of liquid in said holding reservoir and providing a signal upon detecting same, said liquid level detecting means including:i) a sensor element having a portion disposed for detecting a predetermined level of liquid in said holding reservoir, and ii) a means for emitting a signal in response to said sensor detecting said predetermined level of liquid in said holding reservoir.
 8. A patient support apparatus, comprising:a) a frame; b) a support surface conforming to at least a first portion of the patient's body for supporting the patient above said frame; and c) means for managing waste associated with a patient who is supported at least in part on said support surface, said waste managing means being carried by said frame and including:i) means for supporting at least a second portion of the patient coplanar with said support surface, said second portion supporting means being a separate element from said support surface, and ii) means for catching the waste associated with the patient,A) said catching means being supported by said second portion supporting means between the patient and said second portion supporting means.
 9. An apparatus as in claim 8, further comprising: means for adapting said waste managing means to be carried by said frame, said adapting means being supported by said frame and configured for receiving said second portion supporting means.
 10. An apparatus as in claim 8, wherein:B) at least a portion of said catching means being permeable to liquids.
 11. An apparatus as in claim 8, wherein said waste managing means further includes:iii) means for removing the waste from said catching means, said removing means being disposed in communication with said catching means.
 12. A patient support apparatus, comprising:a) a frame; b) a support surface conforming to at least a first portion of the patient's body for supporting the patient above said frame; and c) means for managing waste associated with a patient who is supported at least in part on said support surface, said waste managing means being carried by said frame and including:i) means for supporting at least a second portion of the patient coplanar with said support surface, ii) means for catching the waste associated with the patient,A) said catching means being supported by said second portion supporting means between the patient and said second portion supporting means, and iii) means for removing the waste from said catching means, said removing means being disposed in communication with said catching means, wherein: said removing means includes a holding reservoir and a vacuum blower being connected in communication with said holding reservoir; and e) said removing means further includes a vacuum wand selectively connected in communication with said holding reservoir wherein said vacuum blower can create a suction force in said vacuum wand.
 13. An apparatus as in claim 12, wherein:f) said removing means further includes:i) a rinse solution conduit having one end carried by said vacuum wand, ii) a rinse solution container configured to be removably securable to said frame and connected for communicating with said rinse solution conduit, and iii) a rinse pump connected for pumping rinse solution from said rinse solution container through said rinse solution conduit to be dispensed via said vacuum wand.
 14. An apparatus as in claim 13, further comprising:f) means for activating operation of said rinse pump responsive to the user's access to said vacuum wand.
 15. An apparatus as in claim 13, further comprising:f) means for detecting a predetermined level of liquid in said rinse solution container and providing a signal upon detecting same, said rinse solution level detecting means including:i) a liquid sensor element having a portion disposed for detecting a predetermined level of rinse liquid inside said rinse solution container, and ii) a means for emitting a signal in response to said sensor element detecting said predetermined level of liquid in said rinse solution container.
 16. A low air loss patient support apparatus, comprising:a) a frame; b) a plurality of low air loss sacks,i) said sacks being carried by said frame, ii) said sacks being configured to be connected in communication with a source of pressurized gas and configured to be inflatable with pressurized gas, and iii) said sacks being configured to define a low air loss support surface conforming to at least a first portion of the patient's body for supporting the patient above said frame when said sacks are inflated with pressurized gas; and c) means for managing waste associated with a patient who is supported at least in part on said low air loss support surface, said waste managing means including:i) means for supporting at least a second portion of the patient coplanar with said low air loss support surface of said sacks, and ii) means for catching the waste associated with the patient,A) said catching means being supported by said second portion supporting means between the patient and said second portion supporting means.
 17. An apparatus as in claim 16, further comprising: means for adapting said waste managing means to be carried by said frame, said adapting means being supported by said frame and configured for receiving said second portion supporting means.
 18. An apparatus as in claim 16, wherein said waste managing means further includes:iii) means for removing the waste from said catching means, said removing means being disposed in communication with said catching means.
 19. An apparatus as in claim 18, wherein said waste managing means further includes:iv) means for collecting the waste removed from said catching means by said removing means, said waste collecting means being disposed in communication with said removing means.
 20. A low air loss patient support apparatus, comprising:a) a frame; b) a plurality of low air loss sacks,i) said sacks being carried by said frame, ii) said sacks being configured to be connected in communication with a source of pressurized gas and configured to be inflatable with pressurized gas, and iii) said sacks being configured to define a low air loss support surface conforming to at least a first portion of the patient's body for supporting the patient above said frame when said sacks are inflated with pressurized gas; and c) means for managing waste associated with a patient who is supported at least in part on said low air loss support surface, said waste managing means including:i) means for supporting at least a second portion of the patient coplanar with said low air loss support surface of said sacks, and ii) means for catching the waste associated with the patient,A) said catching means being supported by said second portion supporting means between the patient and said second portion supporting means, wherein: B) at least a portion of said catching means being permeable to liquids.
 21. Apparatus for managing waste from the care and/or treatment of a patient, the apparatus comprising:a) a rinse liquid container; b) a rinse liquid nozzle; c) a heat exchanger; d) a means for carrying liquid between said container and said nozzle via said heat exchanger; and e) a means for controlling the flow of liquid provided to said nozzle.
 22. An apparatus as in claim 21, further comprising:a means for regulating the temperature of liquid provided to said rinse liquid nozzle.
 23. An apparatus as in claim 22, wherein:said means for regulating the temperature of liquid provided to said nozzle includes a mixing valve configured and disposed in communication with said liquid carrying means between said heat exchanger and said nozzle, said mixing valve having an outlet connected in communication with said nozzle.
 24. An apparatus as in claim 23, wherein:said means for controlling the flow of liquid provided to said nozzle includes a rinse solution pump communicating with said liquid carrying means; and said means for regulating the temperature of liquid provided to said nozzle includes:a temperature sensor configured and disposed to sense the temperature of liquid provided from said mixing valve and to provide signals indicating said temperature; and a controller configured and disposed in communication with said temperature sensor to control operation of said pump depending upon signals provided by said temperature sensor.
 25. An apparatus as in claim 21, further comprising:a splash guard configured and disposed to intercept back-splashing liquid dispensed from said nozzle.
 26. An apparatus as in claim 21, further comprising:a means for providing rinse solution on demand to said nozzle and without surges of rinse solution.
 27. An apparatus as in claim 26, wherein said on demand rinse solution means comprises:a rinse solution pump communicating with said liquid carrying means; an elastic accumulator forming part of said liquid carrying means disposed between said pump and said nozzle; and a pressure switch disposed between said pump and said nozzle to sense pressure in said liquid carrying means and said accumulator.
 28. An apparatus as in claim 21, further comprising:means for detecting the level of liquid inside said liquid container, said liquid level detecting means including a capacitive liquid level sensor disposed outside said container to detect a predetermined level of liquid inside said liquid container.
 29. An apparatus as in claim 21, wherein:said liquid container has a bottom, an outlet, and a siphon tube disposed inside said liquid container with a first end in communication with said outlet and a second end disposed opposite said first end and near said bottom, said container including a check valve disposed in said tube.
 30. An apparatus as in claim 21, further comprising:means for receiving said liquid container; and means for positively locking said container into said receiving means wherein said positively locking means includes a spring-biased latching member configured and disposed to engage said liquid container.
 31. An apparatus as in claim 21, further comprising:means for receiving said liquid container; and means for detecting when said liquid container is securably received by said receiving means, wherein said securably received detecting means includes a micro-switch and a spring-biased plunger carried by said receiving means and configured and disposed to activate said micro-switch to a first status when said liquid container is securably received by said receiving means and to activate said micro-switch to a second status when said liquid container is other than securably received by said receiving means.
 32. An apparatus for managing waste arising from at least one of the care, maintenance, and treatment of a patient, the apparatus comprising:a) means for supporting at least a first portion of the patient's body, wherein said first portion supporting means includes:i) a support member configured to contain pressurized air, ii) said support member defining a plurality of discrete elongated cylindrical support fingers disposed adjacent to each other and separated from each other along their lengths thereof, and iii) each said support finger having a free end defining a patient support surface, said patient support surfaces being disposed to support the weight of the first portion of the patient's body; and b) means for catching waste, said waste catching means being carried by said first portion supporting means and wherein said catching means includes:i) a liquid impermeable basin member, ii) said basin member being configured to conform to and receive said support fingers, iii) said basin member being further configured with a floor disposed beneath the upward-most level of said patient support surfaces when said basin member is fitted over said support fingers and receives said support fingers, iv) said basin member being further configured with at least one drain opening defined through said floor, and v) said floor being configured so as to slope toward said at least one drain opening.
 33. An apparatus as in claim 321, further comprising:a frame; and means for adapting said first portion supporting means to be carried by said frame.
 34. An apparatus as in claim 33, wherein said adapting means includes:at least one inflatable slotted cushion having an upper exterior panel and a lower exterior panel, said lower exterior panel defining at least one air supply opening and at least a first elongated opening, said upper panel defining a second elongated opening configured and disposed in registry with said first elongated opening defined in said lower panel, each said elongated opening defining an opposite end of a slot defined through a portion of said cushion.
 35. An apparatus as in claim 33, wherein said adapting means includes:at least one pair of inflatable chambers disposed opposite one another and being configured to be separately inflated and deflated for selectively inflating at least one inflatable chamber while deflating said oppositely disposed chamber, thereby changing the relative height of one of said pair of chambers with respect to the height of said oppositely disposed chamber.
 36. An apparatus as in claim 33, wherein said adapting means includes:at least one peripheral containment cushion disposed to form a border around at least a portion of said first portion supporting means.
 37. An apparatus as in claim 33, further comprising:a plurality of low air loss sacks,i) said sacks being carried by said frame, ii) said sacks being configured to be connected in communication with a source of pressurized gas and configured to be inflatable with pressurized gas, and iii) said sacks being configured to define. a low air loss support surface conforming to at least a second portion of the patient's body for supporting the patient above said frame when said sacks are inflated with pressurized gas; and wherein said means for supporting at least a first portion of the patient is configured to support the first portion of the patient coextensive with said low air loss support surface defined by said sacks.
 38. An apparatus as in claim 32, further comprising:means for turning the patient to facilitate cleansing of waste, said turning means being disposed adjacent said first portion supporting means.
 39. An apparatus as in claim 38, wherein:said turning means includes at least one turning sack and an air flow diverter valve disposed in communication with said turning sack.
 40. An apparatus as in claim 39, wherein:said at least one turning sack including a first envelope configured to be inflated with pressurized air and a first web diagonally disposed within said first envelope to separate said first envelope into at least a first chamber and a second chamber, said first chamber including a bottom wall configured with a first air supply opening, said second chamber including a bottom wall configured with a second air supply opening, said first chamber including a first side wall configured with a first air communication slot, said second chamber including a second side wall configured with a second air communication slot, said at least one turning sack including a second envelope configured to be inflated with pressurized air and a second web diagonally disposed within said second envelope to separate said second envelope into at least a third chamber and a fourth chamber, said third chamber including a third side wall configured with a third air communication slot, said fourth chamber including a fourth side wall configured with a fourth air communication slot, said first air communication slot being connected to communicate with said third air communication slot, said second air communication slot being connected to communicate with said fourth air communication slot.
 41. An apparatus as in claim 38, further comprising:means for preventing operation of said turning means unless at least one predetermined safety condition has been met.
 42. An apparatus as in claim 38, further comprising:means for automatically deflating a portion of said adapting means to facilitate operation of said turning means.
 43. An apparatus as in claim 32, wherein:said catching means further includes:a liquid permeable filter sheet disposed to be carried atop said basin member and detachably securable thereover by at least one pair of substrates carrying hook-and-loop fasteners.
 44. An apparatus as in claim 43, wherein:said filter sheet further includes:a plurality of liquid drainage holes formed in a generally centrally disposed section of said sheet.
 45. An apparatus as in claim 32, further comprising:a waste reservoir connected in communication with said at least one drain opening; a vacuum flow diverter valve disposed between and in communication with said reservoir and said at least one drain opening and being configured to alternate selectably between at least a first orientation and a second orientation; a vacuum wand disposed in communication with said vacuum flow diverter valve and in communication with said reservoir via said first orientation of said vacuum flow diverter valve and in communication with said at least one drain opening via said first orientation of said vacuum flow diverter valve; and wherein said vacuum flow diverter includes a magnet and at least one Hall-effect sensor for detecting when said vacuum flow diverter valve is disposed in said first orientation.
 46. An apparatus as in claim 32, further comprising:a waste reservoir connected in communication with said at least one drain opening; and means for detecting the level of liquid inside said waste reservoir, said liquid waste level detecting means including a capacitive liquid level sensor disposed outside said reservoir to detect a predetermined level of liquid inside said waste reservoir.
 47. An apparatus as in claim 32, further comprising:a waste jug configured to be removably connectable into communication with said at least one drain opening; and, means for detecting the level of liquid inside said waste jug, said waste jug liquid level detecting means including a capacitive liquid level sensor disposed outside said waste jug to detect a predetermined level of liquid inside said waste jug.
 48. An apparatus as in claim 32, further comprising:a waste jug configured to be removably connectable into communication with said at least one drain opening; means for receiving said waste jug; and means for positively locking said waste jug into said receiving means wherein said positively locking means includes a spring-biased latching member configured and disposed to engage said waste jug.
 49. An apparatus as in claim 32, further comprising:a waste jug configured to be removably connectable into communication with said at least one drain opening; and means for receiving said waste jug; and means for detecting when said waste jug is securably received by said receiving means, wherein said securably received detecting means includes a micro-switch and a spring-biased plunger carried by said receiving means and configured and disposed to activate said micro-switch to a first status when said waste jug is securably received by said receiving means and to activate said micro-switch to a second status when said waste jug is other than securably received by said receiving means.
 50. An apparatus as in claim 49, further comprising:a holding reservoir enclosing said separating tube and defining an air outlet.
 51. An apparatus as in claim 50, further comprising:a check valve disposed in communication with said air outlet of said holding reservoir.
 52. An apparatus as in claim 32, further comprising:a means for separating liquid waste from the waste caught by said catching means, said separating means being disposed in communication with said at least one drain opening and including a curved separating tube.
 53. An apparatus as in claim 52, further comprising:a vacuum blower disposed in communication with said separating tube via said air outlet of said holding reservoir. 